- Providers caring for children requiring analgesia in the pediatric emergency department (ED) found intranasal ketamine to be satisfactory and provide a high degree of perceived patient comfort.
- The 3-4 mg/kg dosing range appeared to be the most effective.
- Side effects were mild.
Why this matters
- Few studies have examined the use of intranasal ketamine for children in the ED.
- Median age, 3.8 years.
- Median dose, 3.9 mg/kg.
- Provider satisfaction, 90/100.
- Provider perception of patient comfort, 75/100.
- 7.7% (15) of patients experienced treatment failure requiring procedural sedation with other drugs.
- The group experiencing treatment failure received a similar median dose to their counterparts (3.9 mg/kg).
- 6% (12) of patients experienced adverse events, most commonly nausea.
- 1 patient experienced dysphoria; they had received a dose >5 mg/kg.
- Retrospective chart review of children aged 6 months to 18 years who received intranasal ketamine (n=196), plus a prospective survey of their providers.
- Protocol called for initial dose of 2-5 mg/kg.
- Outcome: provider satisfaction with intranasal ketamine for perceived patient pain, anxiolysis, and agitation, rated on 0-100 scale.
- Funding: NIH.
- Small study without active comparator.
- No details on, e.g., patient satisfaction, onset time, or duration of analgesia.