UMEM Educational Pearls

Category: Pediatrics

Title: What is the optimal dosing for IV ketamine for moderate sedation in children?

Keywords: Ketamine, conscience sedation, pharmacology, pediatrics (PubMed Search)

Posted: 11/18/2016 by Jennifer Guyther, MD
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Question

Using 1.5 mg/kg or 2 mg/kg of IV ketamine led to less redosing compared to using 1 mg/kg IV.

Answer

This was a prospective, double blinded, randomized controlled trial of children 3-18 years.  125 children were included in the study.  They compared 1mg/kg, 1.5 mg/kg and 2 mg/kg doses.  All doses were IV.  Adequate sedation was achieved with all 3 doses of ketamine, and there was no increased risk of adverse events with the higher doses.  However, using 1.5mg/kg or 2 mg/kg required less redosing.

Previous studies suggested a higher risk of adverse events if the initial dose was greater than 2.5 mg/kg or the total dose was more than 5 mg/kg.

 

 

References

Kannikeswaran et al.  Optimal dosing of intravenous ketamine for procedural sedation in children in the ED – a randomized control trial.  American Journal of Emergency Medicine 24 (2016) 1347-1353.