Ketamine: a safe and effective agent for painful procedures in the pediatric burn patient.
Ketamine is an effective agent when used for sedation during painful bedside procedures. We developed a ketamine administration protocol for nonanesthesiologists for the purpose of establishing safe monitoring and documentation during ketamine sedation procedures. From June 1, 2002, through June 30, 2003, a total of 522 sedation events using ketamine were performed; 347 of these events were analyzed. Seventeen (4.9%) events contained potentially adverse outcome indicators, 10 (2.9%) of which required intervention. Eight events were airway related and responded to repositioning, supplemental oxygen, or bag-valve-mask ventilation. Two patients had a decrease in blood pressure, which responded to fluid administration. Total doses of ketamine administered were between 6 and 800 mg, for procedures ranging from 1 to 105 minutes, in patients weighing between 3 and 111 kg. The development of a strict protocol ensures the safe administration of ketamine for the pediatric burn patient.
Shriners Hospital for Children, Northern California Sacramento, California 95817, USA.
Victoria F
VF
Owens
Tina L
TL
Palmieri
Catherine M
CM
Comroe
Janice M
JM
Conroy
John A
JA
Scavone
David G
DG
Greenhalgh
D000293:Adolescent; D000328:Adult; D000778:Anesthetics, Dissociative / Q000008:administration & dosage*; D002056:Burns / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols; D016292:Procedural Sedation; D019937:Diagnostic Techniques and Procedures / Q000009:adverse effects; D005260:Female; D006801:Humans; D007223:Infant; D007262:Infusions, Intravenous; D007649:Ketamine / Q000008:administration & dosage*; D008297:Male; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D012189:Retrospective Studies; D013812:Therapeutics / Q000009:adverse effects
D000778:Anesthetics, Dissociative; D007649:Ketamine