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Procedural Sedation in Children: Ketamine

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Sedation and Analgesia for the Pediatric Intensivist

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Abstract

Ketamine is a dissociative anesthetic agent with analgesic property. It is highly lipophilic with a rapid onset of sedation and analgesia through its action on N-methyl-d-aspartate (NMDA) and opioid receptors. Its ability to preserve respiratory drive and airway reflexes makes it an attractive agent for procedural sedation, and its sympathomimetic effects offer potential benefits to critically ill patients with cardiac instability. However, the psychomimetic side effect of ketamine is not uncommon during the emergence phase of the sedation. Ketamine is also often used as a combination agent with opioids, propofol, and dexmedetomidine for pediatric procedural sedation. In this chapter, we discuss the pharmacology, systemic effects, indications, dosing, and precautions of ketamine.

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Authors and Affiliations

  1. Department of Paediatric Subspecialties, Children’s Intensive Care Unit, KK Women’s and Children’s Hospital, Singapore, Singapore

    Anuradha Menon & Yoke Hwee Chan

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  1. Anuradha Menon
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  2. Yoke Hwee Chan
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Correspondence to Yoke Hwee Chan .

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Editors and Affiliations

  1. Associate Professor of Pediatrics, Emory University School of Medicine, Department of Pediatrics, Division of Pediatric Critical Care Medicine, Children’s Healthcare of Atlanta at Egleston, Atlanta, GA, USA

    Pradip P. Kamat

  2. Professor of Pediatrics/Pediatric Critical Care, University of Louisville, “Just For Kids” Critical Care Center, Norton Children’s Hospital, Louisville, KY, USA

    John W. Berkenbosch

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Menon, A., Chan, Y.H. (2021). Procedural Sedation in Children: Ketamine. In: Kamat, P.P., Berkenbosch, J.W. (eds) Sedation and Analgesia for the Pediatric Intensivist. Springer, Cham. https://doi.org/10.1007/978-3-030-52555-2_30

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  • DOI: https://doi.org/10.1007/978-3-030-52555-2_30

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