Behavioral Changes in Children After Emergency Department Procedural Sedation

Pearce, Jean; Brousseau, David C.; Yan, Ke; Hainsworth, Keri R.; Hoffmann, Raymond G.; Drendel, Amy L.

doi:10.1111/acem.13332

Cited by 17 publications

(6 citation statements)

References 25 publications

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“…The study did not observe any instances of nightmares, dysphoria, or long-term abnormal behavioral changes, suggesting that patients may tolerate the drug well in the long term without significant negative effects. However, Pearce et al [ 25 ] discovered that nearly one in four children experienced substantial negative behavioral changes within 1-2 weeks after discharge from IV ketamine therapy. Furthermore, Meyers et al [ 26 ] conducted a study demonstrating long-term hallucinations in two children following ketamine administration.…”

Section: Reviewmentioning

confidence: 99%

Evaluating the Safety and Efficacy of Ketamine as a Bronchodilator in Pediatric Patients With Acute Asthma Exacerbation: A Review

Binsaeedu,

Prabakar,

Ashkar

et al. 2023

Cureus

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Ketamine has emerged as a potential treatment option for pediatric patients with acute asthma exacerbation who do not respond to standard therapy. This review aims to evaluate the safety and efficacy of ketamine in this population and provide an overview of the current literature. A comprehensive search was conducted in PubMed and Google Scholar, resulting in the identification of four relevant studies. The studies demonstrated that ketamine administration led to improvements in respiratory parameters, including a decrease in clinical asthma scores (CASs) and respiratory rates, and an increase in peak expiratory flow and oxygen saturation. Ketamine infusion also showed promise in obviating the need for intubation in patients with severe wheezing due to bronchiolitis. The most common side effects observed were increased tracheobronchial secretions and hallucinations, which were manageable through discontinuation or additional medication. No significant changes in heart rate and blood pressure were reported, indicating hemodynamic stability. Long-term complications of ketamine use were minimal, with no reports of nightmares or dysphoria. In conclusion, ketamine shows potential as a bronchodilator for pediatric patients with acute asthma exacerbation, although further research is needed to fully evaluate its effectiveness and long-term effects. The use of ketamine should be considered in carefully selected cases and closely monitored for adverse events.

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Section: Reviewmentioning

confidence: 99%

Evaluating the Safety and Efficacy of Ketamine as a Bronchodilator in Pediatric Patients With Acute Asthma Exacerbation: A Review

Binsaeedu,

Prabakar,

Ashkar

et al. 2023

Cureus

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show abstract

“…Ketamine is thought to be a drug of abuse, but many case reports have reported no significant tolerance or psychomimetic effects with long-term use of ketamine infusion [88]. But some research suggests that it can lead to behavioral changes like apathy/withdrawal, separation anxiety, general anxiety, insomnia, and disturbed appetite [89]. Hence, further investigation is needed to assess the long-term complications of chronic ketamine use.…”

Section: Long-term Complicationsmentioning

confidence: 99%

Clinical Uses of Ketamine in Children: A Narrative Review

Bali¹,

Dang²,

Gonzalez³

et al. 2022

Cureus

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Ketamine is a phencyclidine derivative that acts as a noncompetitive N-methyl-D-aspartate as well as a glutamate receptor antagonist. It also has other minor mechanisms that contribute to its extensive drug profile. Ketamine is a bronchodilator and maintains normal airway reflexes and, thus, permits spontaneous respiration. This, coupled with the fact that it produces potent analgesia, makes it highly suitable for children.Despite its many merits, the drug's side effects, along with its cultural image of being a drug of abuse, a drug used in veterinary medicine, or a "date-rape drug" have sullied its reputation within the armamentarium of medicine. Even though it is widely used in developing countries, its use in Western nations has diminished. We have strived to explore the various clinical uses of ketamine in children through this article. In addition, the article also highlights how some of the fears associated with using the drug are unfounded and provides ways by which the drug's side effects can be prevented and managed.

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“…Although pediatric procedural sedation has been found to be safe even when performed by general community emergency physicians, 44 shortterm behavioral changes are seen after sedation in children 1-2 weeks after discharge. 45 Thus, further research and prospective trials are needed that compare traditional strategies with regional methods more likely available at large institutions.…”

Section: Emergency Room/preoperative Managementmentioning

confidence: 99%

Pain Management in Acute Fracture Care

Swarup

Pandya

2021

Journal of the Pediatric Orthopaedic Society of North America

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The management of pediatric and adolescent pain continues to evolve. Pain, as in the adult population, is a complex process modulated by both physiologic and psychological factors. It is essential for the orthopedic clinician who manages pain in the acute setting to not only understand the medical aspects of pain control, but also the larger context in which the injury is taking place. The opioid crisis has changed the manner in which pain management is delivered, and an understanding of pediatric physiology is critical for delivering analgesia. This is particularly important in the setting of acute fracture management. Utilization of anti-inflammatory medications, diversion techniques, and regional anesthesia are integral to management in the emergency room, pre-operatively, intra-operatively, and post-operatively. A multi-faceted, holistic approach is essential to achieve successful clinical outcomes.

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Behavioral Changes in Children After Emergency Department Procedural Sedation

Cited by 17 publications

References 25 publications

Evaluating the Safety and Efficacy of Ketamine as a Bronchodilator in Pediatric Patients With Acute Asthma Exacerbation: A Review

Evaluating the Safety and Efficacy of Ketamine as a Bronchodilator in Pediatric Patients With Acute Asthma Exacerbation: A Review

Clinical Uses of Ketamine in Children: A Narrative Review

Pain Management in Acute Fracture Care

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