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Factors affecting determination of the optimal ketamine dose for pediatric sedation
Ji Young Min1, Jeong-Rim Lee1, Hyun Il Kim1
1Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea.
Insights
Pediatric sedation with ketamine for imaging requires careful dosing. Age and body surface area (BSA) are key factors in determining the appropriate ketamine dose for children undergoing diagnostic imaging.
Area of Science:
- Pediatric Anesthesiology
- Medical Imaging
- Pharmacology
Background:
- Sedation is frequently required for pediatric diagnostic imaging.
- Ketamine is a common sedative agent used in this setting.
- Accurate dosing is crucial for patient safety and procedural success.
Purpose of the Study:
- To identify variables influencing ketamine dosage for pediatric sedation.
- To develop a predictive model for ketamine dose in children undergoing imaging.
Main Methods:
- Retrospective study of 66 pediatric patients (0-18 years) sedated with ketamine.
- Data collected included demographics, imaging type, and ketamine dose.
- Exclusion of patients with adverse events.
Main Results:
- Patient age, height, and body surface area (BSA) were significant factors.
- A multivariate regression model identified age and BSA as predictors.
- The equation: ketamine dose (mg) = -1.62 + 0.7 × age (months) + 36.36 × BSA (m²) was derived.
Conclusions:
- Age and BSA are important considerations for estimating ketamine dosage in pediatric sedation.
- The derived equation can aid in determining appropriate ketamine doses for imaging procedures.
Objective:
Children are sedated before undergoing diagnostic imaging tests in emergency medicine or pediatric sedation anesthesia units. The aim of this study was to identify variables potentially affecting the dose of ketamine required for induction of sedation in pediatric patients undergoing diagnostic imaging.
Methods:
This retrospective study included children aged 0 to 18 years who underwent sedation with ketamine for computed tomography or magnetic resonance imaging in the pediatric sedation anesthesia unit of a tertiary medical center between January 2011 and August 2016. The children's hemodynamic status and depth of sedation were monitored during the examination. We recorded data on demographics, categories of imaging tests, ketamine doses administered, adverse events, respiratory interventions, and duration of sedation. Data for patients who experienced adverse events were excluded.
Results:
Sixty-six patients were included in the final analysis. Univariate linear regression analysis revealed that patient age, height, and body surface area (BSA) affected the sedative dose of ketamine administered. These three variables showed multicollinearity in multivariate linear regression analysis and were analyzed in three separate models. The model with the highest adjusted R-squared value suggested the following equation for determination of the dose of ketamine required to induce sedation: ketamine dose (mg)=-1.62+0.7×age (months)+36.36×BSA (m2).
Conclusion:
Variables such as age and BSA should be considered when estimating the dose of ketamine required for induction of sedation in pediatric patients.
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