2.50
Hdl Handle:
http://hdl.handle.net/10755/162789
Type:
Presentation
Title:
Side Effects of Ketamine Sedation
Abstract:
Side Effects of Ketamine Sedation
Conference Sponsor:Emergency Nurses Association
Conference Year:1998
Author:Roback, Mark, MD
P.I. Institution Name:University of Colorado, The Children's Hospital
Contact Address:, Denver, CO, USA
Co-Authors:Joseph Wathen, MD
Purpose: Ketamine is a unique drug providing sedation, analgesia, and amnesia without respiratory depression. Previous retrospective studies report relatively low numbers and severity of side effects associated with the use of ketamine in pediatrics. The purpose of this study was to investigate the frequency and severity of complications in pediatric patients receiving ketamine, evaluate the effectiveness of ketamine for sedation and analgesia, and assess satisfaction.

Design: A prospective observational design was used.

Sample/Setting: Eligible patients were children between 4 months and 18 years receiving ketamine sedation for outpatient emergency department procedures in an urban pediatric emergency department serving 30,000 patient visits annually.

Methodology: Subjects received ketamine (1 mg/kg) and glycopyrrolate (5 mcg/kg) IV for sedation and were monitored to determine type, severity and frequency of complications. Side effect profiles were noted by nurses directly providing care, nurse and physician review of videos, and phone follow-up to the parents. The Observation Scale of Behavioral Distress (OSBD) was used to compile scores from video reviews to determine effectiveness of sedation; chart review ensured compilation of physician satisfaction and immediate side effects; and calls home recorded delayed side effects and parent satisfaction.

Results: There were 118 patients between 4.5 months and 5 years enrolled. Side effects for the 118 patients were as follows: 23% had emergency phenomena at home, 17% had emergency phenomena at the ED, 17.6% had diplopia, 11.2% had rashes, 9.2% showed random movements, 6.8% experienced hypersalivation, 4.2% had hypertonicity, .9% had apnea, 1.7% had laryngospasm, 16% vomited at the ED, while 8.5% vomited at home. Emergence phenomena consisted of agitation, active dreaming/nightmares, dysphoria, euphoria, and/or hallucinations; the overall incidence of emergency phenomena was 38 of the 118 patients. Overall parent satisfaction was 97%, while physician satisfaction was 95%.

Conclusions: Side effects of ketamine occur more often than previously reported. Specifically, emergence phenomena and vomiting occur more frequently with multiple doses of ketamine. No complications resulted in significant morbidity. Despite side effects, parental and physician satisfaction remained high. With properly trained staff, appropriate airway management equipment, and parent education about possible side effects, ketamine appears to be a useful drug for minor pediatric emergency department procedures providing effective sedation, analgesia, and amnesia. [Research Poster Presentation]
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleSide Effects of Ketamine Sedationen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162789-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Side Effects of Ketamine Sedation</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">1998</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Roback, Mark, MD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Colorado, The Children's Hospital</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">, Denver, CO, USA</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Joseph Wathen, MD</td></tr><tr><td colspan="2" class="item-abstract">Purpose: Ketamine is a unique drug providing sedation, analgesia, and amnesia without respiratory depression. Previous retrospective studies report relatively low numbers and severity of side effects associated with the use of ketamine in pediatrics. The purpose of this study was to investigate the frequency and severity of complications in pediatric patients receiving ketamine, evaluate the effectiveness of ketamine for sedation and analgesia, and assess satisfaction.<br/><br/>Design: A prospective observational design was used.<br/><br/>Sample/Setting: Eligible patients were children between 4 months and 18 years receiving ketamine sedation for outpatient emergency department procedures in an urban pediatric emergency department serving 30,000 patient visits annually.<br/><br/>Methodology: Subjects received ketamine (1 mg/kg) and glycopyrrolate (5 mcg/kg) IV for sedation and were monitored to determine type, severity and frequency of complications. Side effect profiles were noted by nurses directly providing care, nurse and physician review of videos, and phone follow-up to the parents. The Observation Scale of Behavioral Distress (OSBD) was used to compile scores from video reviews to determine effectiveness of sedation; chart review ensured compilation of physician satisfaction and immediate side effects; and calls home recorded delayed side effects and parent satisfaction.<br/><br/>Results: There were 118 patients between 4.5 months and 5 years enrolled. Side effects for the 118 patients were as follows: 23% had emergency phenomena at home, 17% had emergency phenomena at the ED, 17.6% had diplopia, 11.2% had rashes, 9.2% showed random movements, 6.8% experienced hypersalivation, 4.2% had hypertonicity, .9% had apnea, 1.7% had laryngospasm, 16% vomited at the ED, while 8.5% vomited at home. Emergence phenomena consisted of agitation, active dreaming/nightmares, dysphoria, euphoria, and/or hallucinations; the overall incidence of emergency phenomena was 38 of the 118 patients. Overall parent satisfaction was 97%, while physician satisfaction was 95%.<br/><br/>Conclusions: Side effects of ketamine occur more often than previously reported. Specifically, emergence phenomena and vomiting occur more frequently with multiple doses of ketamine. No complications resulted in significant morbidity. Despite side effects, parental and physician satisfaction remained high. With properly trained staff, appropriate airway management equipment, and parent education about possible side effects, ketamine appears to be a useful drug for minor pediatric emergency department procedures providing effective sedation, analgesia, and amnesia. [Research Poster Presentation]</td></tr></table>en_GB
dc.date.available2011-10-27T10:34:11Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:34:11Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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