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Ventilatory response during dissociative sedation in children-a pilot study
Grace Kim1, Steven M Green, T Kent Denmark
1Department of Emergency Medicine, Loma Linda University Medical Center and Children's Hospital, Loma Linda, CA 92354, USA. vtenacious@aol.com
Summary
Ketamine sedation in pediatric emergency patients did not cause respiratory depression. This study found no evidence of hypoventilation or decreased ventilation when using ketamine for procedural sedation.
Area of Science:
- Emergency Medicine
- Pediatric Anesthesiology
- Pharmacology
Background:
- Ketamine is used for procedural sedation in pediatric emergency departments.
- The potential for respiratory depression with ketamine at dissociative doses is not well understood.
Purpose of the Study:
- To evaluate the effects of intravenous ketamine on respiratory function in pediatric patients.
- To assess for subclinical respiratory depression using capnography.
Main Methods:
- A pilot study involving 20 pediatric patients in the emergency department.
- Continuous capnography was used to monitor end-tidal carbon dioxide (EtCO2) and respiratory rate.
- Ketamine was administered intravenously at a dose of 1.5 mg/kg for procedural sedation.
Main Results:
- End-tidal carbon dioxide (EtCO2) and pulse oximetry levels remained stable post-ketamine administration.
- No instances of hypoventilation (EtCO2 > 47 mm Hg) were observed during sedation.
- Respiratory rate and oxygen saturation showed no significant changes.
Conclusions:
- Intravenous ketamine at 1.5 mg/kg for procedural sedation in pediatric patients did not induce respiratory depression.
- The study found no evidence of respiratory depressant effects of ketamine in this setting.