Changes in oxygen saturation following low‐dose intramuscular ketamine in paediatric cardiac surgical patients

Abstract

Forty-seven children with Congenital heart disease received ketamine 3 mg kg-I intramuscularly as a pre-induction agent. During the 10 min observation period following ketamine administration no adverse cardiovascular or respiratory side-effects were seen. Arterial oxygen saturation as measured by pulse oximetry remained constant in all patients. In the group of children with cyanotic heart disease, there was a trend towards improvement of oxygen saturation which became significant 10 min after ketamine administration. We conclude that ketamine is a useful pre-induction agent when used in the appropriate dose range.

Procedural sedation: A review of sedative agents, monitoring, and management of complications

“…[ 27 – 30 ] These effects are generally seen even in patients with congenital heart disease where reports have demonstrated a stable or increased oxygen saturation in patients with cyanotic lesions. [ 31 ] Ketamine's positive inotropic effects, increased heart rate, and increased blood pressure may result in a concomitant increase in myocardial oxygen consumption. This effect can alter the balance between myocardial oxygen demand and delivery, inducing ischemia in patients with ischemic heart disease (a rare event in the pediatric population).…”

The role of ketamine in the current practice of paediatric anaesthesia

“…Ketamine has been included in the recent resurgence of clinical investigations of preanaesthetic medication in paediatrics in which new routes of administration have been examined for both old and new drugs. It has been shown to produce preoperative sedation when administered intranasally (Weksler et al 1993), orally (Gutstein et al 1992), rectally (van der Bijl, Roelofse & Stander 1991), or intramuscularly (Fleischer et al 1991). Similarly, it can provide postoperative sedation and analgesia when administered as a constant intravenous infusion (Hartvig, Larsson & Joachimsson 1993).…”