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Ketamine for short ambulatory procedures in children: an audit
1Department of Anaesthesiology, University Children's Hospital, Zurich, Switzerland.
Background:
The purpose of this audit was the evaluation of recovery and discharge times and the identification of perioperative events related to anaesthetics with intravenous ketamine and midazolam.
Methods:
In our institution, we use this method as a routine technique for short ambulatory emergency or elective procedures. Two hundred children, aged 1-16 years, were included. Ninety percent of the study patients underwent emergency procedures.
Results:
Most perioperative events were minor and easily corrected. Intraoperatively, most events were related to respiration, including oxygen desaturation, apnoea or laryngospasm. Vomiting, vertigo, visual disturbances, nightmares and hallucinations were observed in the postoperative period. Serious complications requiring hospital admission or further interventions in the postoperative period were rare. Mean recovery time was 100 min (range 20-325) and mean discharge time 130 min (range 25-360).
Conclusions:
Intravenous ketamine plus midazolam is a suitable, simple and fast anaesthetic technique for short, painful ambulatory procedures. Considering the possibility of potentially serious respiratory complications, it should be performed only by qualified anaesthesia staff who are trained in advanced airway management.