Intravenous Ketamine Sedation of Pediatric Patients in the Emergency Department

Dachs, Robert; Innes, George

doi:10.1016/s0196-0644(97)70321-4

Cited by 136 publications

(76 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…As expected, the median recovery time of 14 minutes documented in this series was longer than most recovery times reported for propofol alone and shorter than those reported for IV ketamine alone. Previous ED studies using IV ketamine alone have shown median recovery times of 25, 28 58, 31 and 103 minutes. 32 Median recovery time using propofol alone in children has been reported to be between 5 and 15 minutes.…”

Section: Discussionmentioning

confidence: 95%

“…Pediatric PSA with IV ketamine alone is reliably achieved with a dose of 1.5 mg ⁄ kg, while lower doses frequently require repeating. [26][27][28][29][30] It is postulated that by combining ketamine with propofol, clinicians have the ability to provide deep sedation using lower doses of ketamine, which may allow for more rapid recovery. As expected, the median recovery time of 14 minutes documented in this series was longer than most recovery times reported for propofol alone and shorter than those reported for IV ketamine alone.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A Prospective Case Series of Pediatric Procedural Sedation and Analgesia in the Emergency Department Using Single‐syringe Ketamine–Propofol Combination (Ketofol)

Andolfatto

Willman

2010

Academic Emergency Medicine

103

View full text Add to dashboard Cite

Objectives: This study evaluated the effectiveness, recovery time, and adverse event profile of intravenous (IV) ketofol (mixed 1:1 ketamine-propofol) for emergency department (ED) procedural sedation and analgesia (PSA) in children.Methods: Prospective data were collected on all PSA events in a trauma-receiving, community teaching hospital over a 3.5-year period, from which data on all patients under 21 years of age were studied. Patients receiving a single-syringe 1:1 mixture of 10 mg ⁄ mL ketamine and 10 mg ⁄ mL propofol (ketofol) were analyzed. Patients received ketofol in titrated aliquots at the discretion of the treating physician. Effectiveness, recovery time, caregiver and patient satisfaction, drug doses, physiologic data, and adverse events were recorded.Results: Ketofol PSA was performed in 219 patients with a median age of 13 years (range = 1 to 20 years; interquartile range [IQR] = 8 to 16 years) for primarily orthopedic procedures. The median dose of medication administered was 0.8 mg ⁄ kg each of ketamine and propofol (range = 0.2 to 3.0 mg ⁄ kg; IQR = 0.7 to 1.0 mg ⁄ kg). Sedation was effective in all patients. Three patients (1.4%; 95% confidence interval [CI] = 0.0% to 3.0%) had airway events requiring intervention, of which one (0.4%; 95% CI = 0.0% to 1.2%) required positive pressure ventilation. Two patients (0.9%; 95% CI = 0.0% to 2.2%) had unpleasant emergence requiring treatment. All other adverse events were minor. Median recovery time was 14 minutes (range = 3 to 41 minutes; IQR = 11 to 18 minutes). Median staff satisfaction was 10 on a 1-to-10 scale.Conclusions: Pediatric PSA using ketofol is highly effective. Recovery times were short; adverse events were few; and patients, caregivers, and staff were highly satisfied.

show abstract

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

A Prospective Case Series of Pediatric Procedural Sedation and Analgesia in the Emergency Department Using Single‐syringe Ketamine–Propofol Combination (Ketofol)

Andolfatto

Willman

2010

Academic Emergency Medicine

103

View full text Add to dashboard Cite

show abstract

“…Ketamine is effective for sedation and analgesia for painful procedures. It has adverse effects, such as nausea and vomiting after the procedure, and laryngospasm [40]. It is often combined with an anticholinergic for control of secretions.…”

Section: Intravenous Anaestheticsmentioning

confidence: 99%

Sedation/anaesthesia in paediatric radiology

Arlachov¹,

Ganatra²

2012

The British Journal of Radiology

130

View full text Add to dashboard Cite

Objectives In this article we will give a comprehensive literature review on sedation/general anaesthesia (S/GA) and discuss the international variations in practice and options available for S/GA for imaging children. Methods The key articles were obtained primarily from PubMed, MEDLINE, ERIC, NHS Evidence and The Cochrane Library. Results Recently, paediatric radiology has seen a surge of diagnostic and therapeutic procedures, some of which require children to be still and compliant for up to 1 h. It is difficult and sometimes even impossible to obtain quick and high-quality images without employing sedating techniques in certain children. As with any medical procedure, S/GA in radiological practice is not without risks and can have potentially disastrous consequences if mismanaged. In order to reduce any complications and practice safety in radiological units, it is imperative to carry out pre-sedation assessments of children, obtain parental/guardian consent, monitor them closely before, during and after the procedure and have adequate equipment, a safe environment and a well-trained personnel. Conclusion Although the S/GA techniques, sedative drugs and personnel involved vary from country to country, the ultimate goal of S/GA in radiology remains the same; namely, to provide safety and comfort for the patients. Advances in knowledge Imaging children under general anaesthesia is becoming routine and preferred by operators because it ensures patient conformity and provides a more controlled environment.

show abstract

“…[1][2][3][4][5] Accordingly, the Joint Commission on Accreditation of Healthcare Organizations has recently affirmed ED ketamine sedation to be fully compliant with their standards when administered according to a standard protocol. 6 Ketamine sedation has both simplicity and safety: it is given by either intramuscular or intravenous (IV) routes, dependably preserves airway and ventilatory reflexes, and does not require endotracheal intubation.…”

mentioning

confidence: 99%

“…It also provides superior procedural conditions, reliably producing potent analgesia, sedation, anxiolysis, and amnesia at once. [1][2][3][4][5][6][7][8][9][10] This unique dissociative state readily permits performance of extremely painful procedures that would be otherwise difficult or impossible using traditionally titrated benzodiazepines and opiates.…”

mentioning

confidence: 99%

Ketamine in Adults What Emergency Physicians Need to Know about Patient Selection and Emergence Reactions

Green¹,

2000

Academic Emergency Medicine

View full text Add to dashboard Cite

Intravenous Ketamine Sedation of Pediatric Patients in the Emergency Department

Cited by 136 publications

References 11 publications

A Prospective Case Series of Pediatric Procedural Sedation and Analgesia in the Emergency Department Using Single‐syringe Ketamine–Propofol Combination (Ketofol)

A Prospective Case Series of Pediatric Procedural Sedation and Analgesia in the Emergency Department Using Single‐syringe Ketamine–Propofol Combination (Ketofol)

Sedation/anaesthesia in paediatric radiology

Ketamine in Adults What Emergency Physicians Need to Know about Patient Selection and Emergence Reactions

Contact Info

Product

Resources

About