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Ketamine and botulinum: a safe combinationfor the management of childhood strabismus

Manon Owen1, Carmel P Noonan, Mohammed Al-Khalid

  • 1Department of Ophthalmology, Warrington and Halton Hospitals NHS Foundation Trust, Warrington, UK.

Strabismus
|March 17, 2010
PubMed

Insights

Ketamine anesthesia for strabismus surgery in children is generally safe, with a low incidence of side effects like hallucinations and sleep disturbances. Ptosis, a botulinum toxin side effect, typically resolves within six weeks.

Area of Science:

  • Pediatric Anesthesiology
  • Ophthalmology
  • Pharmacology

Background:

  • Strabismus correction in children often involves botulinum toxin injections.
  • Ketamine is used for anesthesia in pediatric procedures.
  • Evaluating side effects of ketamine and botulinum toxin is crucial for patient safety.

Purpose of the Study:

  • To determine the prevalence of ketamine side effects in children undergoing botulinum toxin injections for strabismus.
  • To assess the incidence, severity, and duration of ptosis following botulinum toxin treatment.

Main Methods:

  • Retrospective review of children who received ketamine anesthesia for strabismus surgery (1999-2006).
  • Parental questionnaires assessed ketamine side effects (nightmares, sleepless nights, hallucinations) and ptosis.
  • Telephone follow-up and medical record analysis provided further details.

Main Results:

  • 12.4% of patients (12/97) experienced emergence reactions to ketamine.
  • Two children had multiple ketamine side effects; ten had a single side effect.
  • 18.6% of patients (18/97) developed ptosis, most resolving within 6 weeks.
  • No life-threatening or sight-threatening adverse events were reported.

Conclusions:

  • Intravenous ketamine anesthesia is a safe option for pediatric strabismus surgery with botulinum toxin.
  • Potential side effects of ketamine include hallucinations and sleep disturbances.
  • Ptosis is a common but generally transient side effect of botulinum toxin treatment for strabismus.
Abstract

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