目的:本研究的目的是确定90天或更小的儿科急诊科患者氯胺酮给药不良事件的发生率,以证明该患者人群给药的安全性和有效性。
方法:对在儿科急诊科接受氯胺酮治疗的90天或更小的患者进行了为期8年的回顾性分析。所有符合年龄标准的患者均纳入本研究。确定的氯胺酮给药途径包括口服,肌肉内,和静脉注射。
结果:14例符合纳入标准的患者被纳入最终分析。中位年龄为45天。氯胺酮给药的适应症包括7例程序性镇静,5例RSI,2例为插管后镇静。口服氯胺酮的平均剂量(mg/kg)为10、4.43和1.59,肌肉内,和静脉途径,分别。在14名患者中,1名患者被鉴定为具有氯胺酮给药的不良事件。在对RSI进行喉镜检查期间,观察到由于喉痉挛引起的一过性去饱和和心动过缓事件,该事件通过使用抗胆碱能药和麻痹药以及成功的插管和通气得以解决。
结论:在这项研究中,1例患者在插管期间由于喉痉挛而遭受不良事件。在儿科人群中,氯胺酮给药的不良事件的发生率在目前的文献中被发现是可变的,范围为0.71%至7.26%。在我们的研究中,14次给药中有1次发生不良事件(7.1%).在我们的90天或更小的患者中,与氯胺酮给药相关的不良事件的发生率似乎与一般儿科人群中报道的相似。
OBJECTIVE: The aim of this study was to identify the incidence of adverse events of ketamine administration in the pediatric emergency department in patients aged 90 days or younger in order to demonstrate the safety and efficacy of administration in this patient population.
METHODS: An 8-year retrospective chart review of patients aged 90 days or younger who received ketamine in the pediatric emergency department was conducted. All patients who met the age criteria were included in this study. Identified routes of ketamine administration included oral, intramuscular, and intravenous.
RESULTS: Fourteen patients were identified who met the inclusion criteria and were included in the final analysis. The median age was 45 days old. Indications for ketamine administration included 7 cases for procedural sedation, 5 cases for RSI, and 2 cases for postintubation sedation. The average dose amount (mg/kg) of ketamine administered was 10, 4.43, and 1.59 for oral, intramuscular, and intravenous routes, respectively. Of the 14 patients, 1 patient was identified to have an adverse event to ketamine administration. A transient desaturation and bradycardic event due to laryngospasm was observed during laryngoscopy performed for RSI that was resolved with administration of anticholinergics and paralytics as well as successful intubation and ventilation.
CONCLUSIONS: In this study, 1 patient suffered an adverse event due to laryngospasm during intubation. In the pediatric population, the incidence of adverse events of ketamine administration has been found to be variable in the current literature, ranging from 0.71% to 7.26%. In our study, an adverse event occurred in 1 out of 14 administrations (7.1%). The incidence of adverse events associated with ketamine administration in our patients aged 90 days or less appeared to be similar to that reported in the general pediatric population.