Prospective age-based comparison of behavioral reactions occurring after ketamine sedation in the ED.
The study objective was to prospectively evaluate the frequency and severity of behavioral reactions occurring in children receiving ketamine sedation in the emergency department (ED). A behavioral observational study was conducted. Ketamine was given in a standardized protocol with midazolam, atropine, and a prehypnotic suggestion. Descriptions of behavioral reactions were recorded immediately after the procedure, and longitudinal follow-up was made in 1 day, 1 week, and 1 month. A total of 301 patients were enrolled. Mild reactions described as not unpleasant occurred in 7/205 (3.4%, 95% CI 0.9-5.9%) of the younger age group, and 2/96 (2.1%, 95% CI 0-5.0%) of the older age group. Unpleasant reactions occurred in 2/205 (1.0%, 95% CI 0-2.4%) of the younger age group, and 4/96 (4.2%, 95% CI 0-8.2%) of the older age group. We observed no clinically important difference in the proportion of older versus younger children experiencing behavioral reactions after IV ketamine sedation.
Hostetler
Mark A
MA
Department of Pediatrics, Division of Emergency Medicine, St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, MO 63110, USA. hostetler m@kids.wustl.edu
Davis
Colleen O
CO
D000759:Adjuvants, Anesthesia / Q000008:administration & dosage; D000293:Adolescent; D000367:Age Factors; D000762:Anesthesia Recovery Period; D000778:Anesthetics, Dissociative / Q000009:adverse effects*; D001285:Atropine / Q000008:administration & dosage; D002648:Child; D002652:Child Behavior / Q000187:drug effects* / Q000523:psychology; D002675:Child, Preschool; D016292:Procedural Sedation / Q000009:adverse effects*; D004325:Dreams / Q000187:drug effects* / Q000523:psychology; D004359:Drug Therapy, Combination; D004638:Emergency Treatment / Q000009:adverse effects; D005260:Female; D006212:Hallucinations / Q000139:chemically induced* / Q000523:psychology; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D007223:Infant; D007231:Infant, Newborn; D007649:Ketamine / Q000009:adverse effects*; D008297:Male; D008874:Midazolam / Q000008:administration & dosage; D011446:Prospective Studies; D012720:Severity of Illness Index
D000759:Adjuvants, Anesthesia; D000778:Anesthetics, Dissociative; D006993:Hypnotics and Sedatives; D007649:Ketamine; D001285:Atropine; D008874:Midazolam