Ketamine and intraocular pressure in children

We determine the increase in intraocular pressure during pediatric procedural sedation with ketamine, and the proportion of children whose increase might be clinically important (at least 5 mm Hg).

We prospectively enrolled children aged 8 to 18 years, chosen to receive ketamine sedation in a pediatric emergency department. We measured intraocular pressure before sedation, immediately after ketamine administration, 2 minutes post-drug administration, and every 5 minutes thereafter until recovery or 30 minutes after the final dose. We descriptively report our observations.

For the 60 children enrolled, the median intraocular pressure increase was 3 mm Hg (range 0 to 8 mm Hg). Fifteen children had a brief greater than or equal to 5 mm Hg increase in intraocular pressure from baseline.

In this study of ketamine sedation in children with healthy eyes, we observed mild increases in intraocular pressure that at times transiently exceeded our bounds for potential clinical importance (5 mm Hg).