Advantages of ketamine in pediatric anesthesia

Alessandro Simonini, Etrusca Brogi, Marco Cascella, Alessandro Vittori, Alessandro Simonini, Etrusca Brogi, Marco Cascella, Alessandro Vittori

Abstract

Although ketamine is primarily used for induction and maintenance of general anesthesia, it also presents sedative, amnestic, anesthetics, analgesic, antihyperalgesia, neuroprotective, anti-inflammatory, immunomodulant, and antidepressant effects. Its unique pharmacodynamics and pharmacokinetic properties allow the use of ketamine in various clinical settings including sedation, ambulatory anesthesia, and intensive care practices. It has also adopted to manage acute and chronic pain management. Clinically, ketamine produces dissociative sedation, analgesia, and amnesia while maintaining laryngeal reflexes, with respiratory and cardiovascular stability. Notably, it does not cause respiratory depression, maintaining both the hypercapnic reflex and the residual functional capacity with a moderate bronchodilation effect. In the pediatric population, ketamine can be administered through practically all routes, making it an advantageous drug for the sedation required setting such as placement of difficult vascular access and in uncooperative and oppositional children. Consequently, ketamine is indicated in prehospital induction of anesthesia, induction of anesthesia in potentially hemodynamic unstable patients, and in patients at risk of bronchospasm. Even more, ketamine does not increase intracranial pressure, and it can be safely used also in patients with traumatic brain injuries. This article is aimed to provide a brief and practical summary of the role of ketamine in the pediatric field.

Keywords: anesthesia; intensive care; ketamine; pediatrics; sedation.

Conflict of interest statement

Conflict of interest: Dr Alessandro Vittori serve as Editor for Open Medicine, but it didn’t affected the peer-review process.

© 2022 Alessandro Simonini et al., published by De Gruyter.

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Source: PubMed

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