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Intranasal dexmedetomidine and rectal ketamine for young children undergoing burn wound procedures

Andrea Frestadius1, Filip Grehn2, Morten Kildal3

  • 1Burn Center, Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital, 751 85 Uppsala, Sweden.

Burns : Journal of the International Society for Burn Injuries
|December 13, 2021
PubMed

Insights

Intranasal dexmedetomidine and rectal ketamine offer safe procedural sedation for pediatric burn patients. This combination effectively manages pain and provides stable sedation, though some cases may require additional anesthesia.

Area of Science:

  • Pediatric Anesthesiology
  • Burn Management
  • Pharmacology

Background:

  • Effective sedation and analgesia are critical for pediatric burn patients undergoing painful procedures.
  • Current methods require evaluation for safety and efficacy in this vulnerable population.

Purpose of the Study:

  • To assess the safety and efficacy of intranasal dexmedetomidine combined with rectal ketamine for procedural sedation in young children with burn wounds.
  • To evaluate complications, adverse effects, pain levels, sedation depth, and recovery times.

Main Methods:

  • Retrospective analysis of electronic health records from 90 procedures in 58 pediatric patients (<5 years old).
  • Assessment of safety and efficacy based on documented outcomes including adverse events and pain scores.

Main Results:

  • No significant adverse events requiring acute airway management or medical intervention occurred in 90 sedations.
  • The dexmedetomidine-ketamine combination provided effective analgesia during procedures and for postoperative pain, with 7.8% of patients requiring conversion to intravenous anesthesia.
  • Two cases experienced delayed awakening (>120 min recovery time), and 23% required additional doses of either agent.

Conclusions:

  • Intranasal dexmedetomidine and rectal ketamine represent a safe and reliable sedation and analgesia strategy for pediatric burn wound procedures.
  • This combination ensures a clinically stable sedative condition that necessitates only basic monitoring.
Abstract

Keywords:
AnalgesiaIntranasalPediatric burnsRectalSafetySedation

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