TY - JOUR
T1 - Ketamine sedation for pediatric critical care procedures
AU - Green, Steven M.
AU - Denmark, T. Kent
AU - Cline, Jon
AU - Roghair, Chad
AU - Allah, Shamel Abd
AU - Rothrock, Steven G.
PY - 2001/9/4
Y1 - 2001/9/4
N2 - Objectives: To describe our experience using ketamine sedation to facilitate pediatric critical care procedures, and to document the safety profile of ketamine in this setting. Design: Retrospective consecutive case series. Setting: Pediatric intensive care unit of a tertiary children's hospital. Patients: Children receiving ketamine for procedural sedation over a 5-year period. Interventions: We reviewed patient records to determine indication, dosing, adverse events, inadequate sedation, and recovery time for each sedation. Outcome Measures: Descriptive features of sedation including adverse events. Results: During the study period, children in our pediatric intensive care unit received ketamine at total of 442 times to facilitate a wide variety of critical care procedures, most commonly central line placement, esophagogastroduodenoscopy, and wound debridement. Most study children had substantial underlying illness (ASA ≥ 3 in 88%; ASA ≥ 4 in 39%). Inadequate sedation was noted in only nine (2%) procedures. Adverse effects included transient laryngospasm (n = 9), transient partial airway obstruction (n = 5), apnea with bradycardia (n = 1), emesis during the procedure (n = 2), emesis during recovery (n = 9), mild recovery agitation (n = 10), moderate-to-severe recovery agitation (n = 1), and excessive salivation (n = 4). There were no adverse outcomes attributable to ketamine. Conclusion: Pediatric intensivists skilled in ketamine administration can safely and effectively administer this drug to facilitate critical care procedures. Despite the ill nature of our patient sample, adverse effects were uncommon.
AB - Objectives: To describe our experience using ketamine sedation to facilitate pediatric critical care procedures, and to document the safety profile of ketamine in this setting. Design: Retrospective consecutive case series. Setting: Pediatric intensive care unit of a tertiary children's hospital. Patients: Children receiving ketamine for procedural sedation over a 5-year period. Interventions: We reviewed patient records to determine indication, dosing, adverse events, inadequate sedation, and recovery time for each sedation. Outcome Measures: Descriptive features of sedation including adverse events. Results: During the study period, children in our pediatric intensive care unit received ketamine at total of 442 times to facilitate a wide variety of critical care procedures, most commonly central line placement, esophagogastroduodenoscopy, and wound debridement. Most study children had substantial underlying illness (ASA ≥ 3 in 88%; ASA ≥ 4 in 39%). Inadequate sedation was noted in only nine (2%) procedures. Adverse effects included transient laryngospasm (n = 9), transient partial airway obstruction (n = 5), apnea with bradycardia (n = 1), emesis during the procedure (n = 2), emesis during recovery (n = 9), mild recovery agitation (n = 10), moderate-to-severe recovery agitation (n = 1), and excessive salivation (n = 4). There were no adverse outcomes attributable to ketamine. Conclusion: Pediatric intensivists skilled in ketamine administration can safely and effectively administer this drug to facilitate critical care procedures. Despite the ill nature of our patient sample, adverse effects were uncommon.
KW - Ketamine
KW - Procedures
KW - Sedation
UR - http://www.scopus.com/inward/record.url?scp=0034851963&partnerID=8YFLogxK
U2 - 10.1097/00006565-200108000-00004
DO - 10.1097/00006565-200108000-00004
M3 - Article
C2 - 11493822
AN - SCOPUS:0034851963
SN - 0749-5161
VL - 17
SP - 244
EP - 248
JO - Pediatric Emergency Care
JF - Pediatric Emergency Care
IS - 4
ER -