UMEM Educational Pearls

Category: Pediatrics

Title: Intranasal Ketamine

Posted: 1/10/2015 by Rose Chasm, MD (Updated: 6/14/2024)
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  • Ketamine popularity for procedural sedation is on the rise, again.  It provides pain relief, sedation, and memory loss while maintaining airway reflexes and has little effect on the heart. 
  • Traditional administration has been the intravenous or intramuscular route, but consider intransal now. 
  • Recent articles have touted the intranasal administration of ketamine for pediatric procedural sedation with good success.
  • Admittedly, the number of patients enrolled in the studies to date have been small and the dosages have varied from 1 to 9 mg/kg/dose.  However, none of the studies have reported any bad outcomes or complications.
  • So, consider IN ketamine for your next pediatric procedural sedation. 



Andolfatto G, et al. Intranasal ketamine for analgesia in theemergency department: a prospective observational study.  Acad Emerg Med. 2013. Oct;20(10):1050-4.

Tsze DS, et al. Intranasal ketamine for procedural sedation in pediatric laceration repair: a preliminary report. Pediatr Emerg Care. 2012. August;28(8);767-70.

Hall D, et al. Intranasal ketamine for procedural sedation. Emerg Med J. 2014;31:789-90.