Use of intramuscular ketamine for endoscopy sedation in children.
OBJECTIVE
To report the experience of the use of intramuscular (IM) ketamine for endoscopy sedation in children.


METHODS
Children over 6 months of age scheduled for elective endoscopy - esophagogastroduodenoscopy (EGD), bronchoscopy and nasopharyngolaryngoscopy (NPL) were enrolled for (2 mg/kg to 3 mg/kg) intramuscular ketamine sedation. A repeated dose of 2 mg/kg intramuscular ketamine was administered to those who failed the first sedation. Alternative sedation (intravenous midazolam and fentanyl) was given to children who failed ketamine sedation twice. Sedation was regarded as successful if the procedure was completed by endoscopist with a single dose of ketamine.


RESULTS
Sixty children were enrolled for the study. Overall success rate in our patients was 78.3%. Failure rate in infants was 50%, i.e. 4 out of 8. For children aged 1-7, the failure rate was 32%. Failure rate dropped markedly to 6.7% for those older than 7 years of age, and it showed significant difference when compared with the other two groups. Two cases of laryngospasm were experienced in the present study.


CONCLUSIONS
Intramuscular ketamine is an effective medication for sedation in endoscopy undertaken in children over age 7 years, but it should be avoided with children under age 7 because of the high failure rate.
Law
Albert K
AK
Department of Paediatrics, Kwong Wah Hospital, Hong Kong, China.
Ng
Daniel K
DK
Chan
Keung-Kit
KK
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation; D005260:Female; D006801:Humans; D007223:Infant; D007273:Injections, Intramuscular; D007649:Ketamine / Q000008:administration & dosage; D008297:Male; D011446:Prospective Studies
D007649:Ketamine