Side Effects of Ketamine in Pediatric Anesthesia

HOLLIStER, G. R.; Burn, James M.B.; Smith, R. M.

doi:10.1097/00132586-197504000-00053

Cited by 29 publications

(18 citation statements)

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“…A rationale for slow administration of ketamine over 30-60 seconds is the concern for respiratory depression noted in early studies. In some of these studies, patients received higher doses of ketamine (≥ 2mg/kg) 5,38 and in other studies there were anecdotal reports of respiratory depression without mention of the dose administered 39,40 . Green et al 14 , in their meta-analysis concluded that intravenous doses of ketamine ≥ 2.5 mg/kg or total doses ≥ 5.0 mg/kg are independent predictors of airway and respiratory adverse events with ketamine sedation.…”

Section: Discussionmentioning

confidence: 99%

Rapid Administration Technique of Ketamine for Pediatric Forearm Fracture Reduction: A Dose-Finding Study

Chinta¹,

Schrock²,

McAllister³

et al. 2015

Annals of Emergency Medicine

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Study Objective To estimate the minimum dose and total sedation time of rapidly infused ketamine that achieves 3-5 minutes of effective sedation in children undergoing forearm fracture reduction in the emergency department. Methods We used the Up-Down method to estimate the median dose of intravenous ketamine infused over ≤ 5 sec that provided effective sedation in 50% (ED50) and 95% (ED95) of healthy children aged 2-5, 6-11 or 12-17 years undergoing forearm fracture reduction. Most were pretreated with opioids. Three investigators blinded to ketamine dose independently graded sedation effectiveness by viewing a video recording of the first 5 minutes of sedation. Recovery was assessed by Modified Aldrete score. Results We enrolled 20 children in each age group. The estimated ED50 was 0.7, 0.5 and 0.6 mg/kg and the estimated ED95 was 0.7, 0.7 and 0.8 mg/kg for the 2-5, 6-11 and 12-17 years age groups, respectively. For the 2-5 years age group, an empirically derived ED95 was 0.8 mg/kg. All who received the empirically derived ED95 in the 2-5 years group or the estimated ED95 in the 6-11 and 12-17 years group had effective sedation. The median total sedation time for the three age groups respectively, was 25, 22.5 and 25 minutes if one dose of ketamine was administered and 35, 25 and 45 minutes if additional doses were administered. No participant experienced serious adverse events. Conclusions We estimated ED50 and ED95 for rapidly infused ketamine for three age groups undergoing fracture reduction. Total sedation time was shorter than most previous studies.

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Section: Discussionmentioning

confidence: 99%

Rapid Administration Technique of Ketamine for Pediatric Forearm Fracture Reduction: A Dose-Finding Study

Chinta¹,

Schrock²,

McAllister³

et al. 2015

Annals of Emergency Medicine

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“…Ketamine is a unique general anesthetic agent as it provides analgesia while maintaining cardiovascular stability, except for patients with severe ventricular dysfunction. However, many patients that receive ketamine require ventilator support . Ketamine is often used to achieve sedation and is used by anesthesiologists as an analgesia agent in children as it is one of the safest sedatives.…”

Section: Discussionmentioning

confidence: 99%

A minimally painful, comfortable, and safe technique for hemodialysis catheter placement in children: Superficial cervical plexus block

Çiftçi

Daşkaya

Yıldırım

et al. 2014

Hemodialysis International

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The superficial cervical plexus block (SCPB) is utilized in pediatric patients to perform certain surgical procedures, but there is no evidence supporting its use in hemodialysis catheter placement. We evaluated the analgesic effectiveness, intraoperative complications, and patient satisfaction associated with SCPB for pediatric patients in renal failure undergoing emergent dialysis catheterization. A total of 52 patients ranging from 1 to 17 years old that required emergent dialysis catheter placement and received SCPB were included in this study. During the catheterization, intraoperative pain scores, requirement for additional analgesia, catheterization access site, and intraoperative complications were recorded. The Children's Hospital of Eastern Ontario Pain Scale (mCHEOPS) was used to determine pain ratings during skin puncture with the needle, skin dilatation, and securing the catheter with stitches. The patients had an average age of 8.46 ± 5.3 years. The preferred catheterization entry site was through right internal jugular vein, which was achieved in 80.7% of patients. However, 19.3% of patients required access through the right subclavian vein. The average mCHEOPS score during skin puncture was 1.4 ± 0.5, and the mean mCHEOPS score was 2.3 ± 0.6 for skin dilatation. Finally, the average mCHEOPS score while securing the catheter with stitches was 1.3 ± 0.4. No patient required fentanyl for additional analgesia. No intraoperative complications occurred. The benefits gained from using SCPB performed by an experienced anesthesiologist for hemodialysis catheter placement include providing sufficient analgesia and optimal surgical conditions while avoiding the complications associated with general anesthesia for pediatric patients with renal failure.

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“…glycopyrrolate. The well‐known high frequency of nausea after ketamine in children ( 22) may explain why eating was also impaired after ketamine without glycopyrrolate.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of premedication with oral ketamine for day‐case adenoidectomy compared with rectal diazepam/diclofenac and EMLA^®

Filatov¹,

Baer²,

Rorarius³

et al. 2000

Acta Anaesthesiol Scand

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Side Effects of Ketamine in Pediatric Anesthesia

Cited by 29 publications

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Rapid Administration Technique of Ketamine for Pediatric Forearm Fracture Reduction: A Dose-Finding Study

Rapid Administration Technique of Ketamine for Pediatric Forearm Fracture Reduction: A Dose-Finding Study

A minimally painful, comfortable, and safe technique for hemodialysis catheter placement in children: Superficial cervical plexus block

Efficacy and safety of premedication with oral ketamine for day‐case adenoidectomy compared with rectal diazepam/diclofenac and EMLA^®

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Side Effects of Ketamine in Pediatric Anesthesia

Cited by 29 publications

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Rapid Administration Technique of Ketamine for Pediatric Forearm Fracture Reduction: A Dose-Finding Study

Rapid Administration Technique of Ketamine for Pediatric Forearm Fracture Reduction: A Dose-Finding Study

A minimally painful, comfortable, and safe technique for hemodialysis catheter placement in children: Superficial cervical plexus block

Efficacy and safety of premedication with oral ketamine for day‐case adenoidectomy compared with rectal diazepam/diclofenac and EMLA®

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Efficacy and safety of premedication with oral ketamine for day‐case adenoidectomy compared with rectal diazepam/diclofenac and EMLA^®