Ketamine sedation for pediatric critical care procedures

Sm, Green; Tk, Denmark; J, Cline; Roghair, C; S, Abd Allah; Sg, Rothrock

doi:10.1097/00006565-200108000-00004

Cited by 83 publications

(46 citation statements)

References 26 publications

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“…The reported incidence of inadequate sedation or the need for additional intervention during MRI sedation with ketamine or propofol is between 2 and 5% respectively. 10,11 Our study yielded similar results, with a superior profile for sevoflurane in a mixture of 50% nitrous oxide-oxygen compared to the other two agents in terms of the sedation success score and requirement for rescue agent.…”

Section: Discussionsupporting

confidence: 66%

Sedation with Ketamine, Propofol or Sevoflurane for Pediatric Patients Undergoing Magnetic Resonance Imaging: An Observational Study

Altun¹,

Seyhan²,

Varansu³

et al. 2016

Turkiye Klinikleri J Anest Reanim

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A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : Sedation is necessary frequently needed in children undergoing magnetic resonance imaging (MRI) to avoid motion. The purpose of present observational cross-sectional study is to investigate the success of three different sedation regimens including ketamine, propofol and sevoflurane in a mixture of 50% nitrous oxide-oxygen which are routinely used in our institution for pediatric sedation during MRI following midazolam premedication. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : Three hundred and seventy children (age 0-14 year) were enrolled to the study. Sedation was achieved in 125 children with ketamine, in 130 children with propofol and in 115 children with sevoflurane in a mixture of 50% nitrous oxide-oxygen. Comparison was performed among the groups for number of failures by excessive movements, numbers of rescue, adverse effects, sedation time and recovery time. Descriptive and parametric statistics (ANOVA) were utilized to look for significant differences. R Re es su ul lt ts s: : Children were similar in demographic characteristics. The comparison of three regimes in term of success according to the movements affecting imaging and requirement for rescue drug showed that minimal mobility which affects imaging and requires less rescue drug was achieved with sevoflurane in a mixture of 50% nitrous oxide-oxygen rather than propofol and ketamine. Although during MR imaging patients in Group ketamine required fewer numbers of rescue intervention to resolve the respiratory problems, desaturation by opening the airway by repositioning the head and neck and increasing the oxygen supply than the other two groups, rescue drug requirement was found more than Sevoflurane group. C Co on nc cl lu us si io on n: : In this study three different sedation regimens were compared according to the mobility which affects imaging and rescue for drug requirement and Sevoflurane in a mixture of 50% nitrous oxide-oxygen -based MRI sedation regimen in children is associated with lower movement, lower requirement for rescue drug, less side effects and higher success compared to ketamine and propofol. K Ke ey y W Wo or rd ds s: : Diffusion magnetic resonance imaging; conscious sedation; ketamine; propofol; sevoflurane Ö ÖZ ZE ET T A Am ma aç ç: : Çocuklarda Manyetik Rezonans (MR) çekimi sırasında hareketi önlemek amacıyla sıklıkla sedasyona ihtiyaç vardır. Bu gözlemsel kesitsel çalışmanın amacı, kurumumuzda MR görüntüleme esnasında midazolam premedikasyonunu takiben çocukların sedasyonunda rutin olarak kullandığımız Ketamin, Propofol ve Sevofluran+%50 nitröz oksit-oksijen kombinasyonu içeren üç farklı sedasyon rejiminin başarısını araştırmaktır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Çalışmaya 0-14 yaş arası 370 çocuk dahil edildi. Oral midazolam premedikasyonunu takiben, çocukların 125'inde sedasyon iv. Ketamin (K), 130'unda iv. Propofol (P), ve 115'inde Sevofluran (S) + %50 nitröz oksit-oksijen kombinasyonu ile sağlandı. Gruplar arası karşılaştı...

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Section: Discussionsupporting

confidence: 66%

Sedation with Ketamine, Propofol or Sevoflurane for Pediatric Patients Undergoing Magnetic Resonance Imaging: An Observational Study

Altun¹,

Seyhan²,

Varansu³

et al. 2016

Turkiye Klinikleri J Anest Reanim

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“…It has been shown to be safe and effective for sedation in pediatric critical care procedures. 52 It increases muscle tone and blood pressure, thus maintaining hemodynamic stability. Ketamine does not cause respiratory depression and maintains respiratory drive.…”

Section: Methadonementioning

confidence: 99%

Pharmacological approaches to the management of pain in the neonatal intensive care unit

Anand

2007

J Perinatol

103

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Effective and consistent management of neonatal pain remains a controversial issue.Premature infants are repeatedly subjected to painful tests and procedures or suffer painful conditions when they are most vulnerable. With different mechanisms transducing various types of pain the practice of 'one-drug fits all' becomes questionable.Clinicians must use the latest non-pharmacologic and pharmacologic therapies for effective management of neonatal pain, distress, or agitation. Pharmacologic strategies for dealing with neonatal pain in the neonatal intensive care unit are described. Opioid therapy, once considered the mainstay for neonatal analgesia, may not be as effective as previously thought. Morphine infusions do not alter the neurological outcomes of preterm neonates and may not be effective against acute pain. Alternative approaches with methadone, ketamine, or local anesthetics should be considered. Clinicians must understand the contextual circumstances underlying pain in individual neonates and tailor therapy accordingly, using the most current evidence related to neonatal pain assessment and management.

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“…S obzirom na to da se pacijenti koji su urgentno primljeni najčešće hospitalizuju u Jedinicama intenzivnog lečenja, često je neophodno nastaviti sa njihovom sedacijom. Skale sa najvećom vrednosti u proceni nivoa sedacije su Sedation Agitation Scale (SAS) i Richmond Agitation Sedation Scale (RASS )(B) 10 .…”

Section: Monitoring Dubine Sedacijeunclassified

Sedation and the potential application of dexmedetomidine: Sedation and dexmedetomidine

Lađević¹,

Mimić²,

Durutović³

et al. 2016

Serb J Anes Inten Therap

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Summary Minimal Sedation (Anxiolysis) is a drug-induced state during which patients respond normally to verbal commands. Although cognitive function and physical coordination may be impaired, airway reflexes, and ventilatory and cardiovascular functions are unaffected. Moderate Sedation/Analgesia ("Conscious Sedation") is a drug-induced depression of consciousness during whichUmerena sedacija/analgezija ("svesna sedacija") je lekovima izazvana depresija svesti. Pacijent odgovara na verbalne komande spontano ili udruže-no sa blažim taktilnim stimulusima. Spontana ventilacija je adekvatna, a funkcija kardiovaskularnog sistema je očuvana. Ovo je najčešći i najpoželjniji vid sedacije na odeljenjima urgentne medicine. Najčešće se postiže kombinacijom opioida i benzodiazepina.Duboka sedacija/analgezija je lekovima izazvana depresija svesti. Pacijent ne može biti lako

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Ketamine sedation for pediatric critical care procedures

Abstract: 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.

Cited by 83 publications

References 26 publications

Sedation with Ketamine, Propofol or Sevoflurane for Pediatric Patients Undergoing Magnetic Resonance Imaging: An Observational Study

Sedation with Ketamine, Propofol or Sevoflurane for Pediatric Patients Undergoing Magnetic Resonance Imaging: An Observational Study

Pharmacological approaches to the management of pain in the neonatal intensive care unit

Sedation and the potential application of dexmedetomidine: Sedation and dexmedetomidine

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