Delayed Effect After Procedural Sedation With Oral Ketamine and Midazolam: A Case Series

Area of Science:

• Pediatric Emergency Medicine
• Pharmacology
• Sedation Management

Background:

• A previous report detailed the use of oral ketamine and midazolam for pediatric procedural sedation.
• The regimen involved 6 mg/kg oral ketamine (max 200 mg) and 0.5 mg/kg oral midazolam (max 15 mg).

Purpose of the Study:

• To report on potential delayed adverse effects of a specific oral ketamine and midazolam sedation regimen in pediatric patients.
• To evaluate the safety and limitations of this combined oral sedation protocol.

Main Methods:

• Case report of two pediatric patients who received oral ketamine and midazolam for procedural sedation.
• Monitoring for adverse respiratory events following the administration of the sedation regimen.

Main Results:

• Both patients experienced respiratory depression after a period of apparent recovery from sedation.
• This indicates a potential for delayed adverse effects with this oral sedation combination.

Conclusions:

• Oral ketamine and midazolam may exhibit a delayed sedative effect.
• The potential for delayed respiratory depression may limit the clinical utility of this specific oral sedation regimen in pediatric emergency settings.