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Pain Manag. 2018 Nov 1;8(6):495-503. doi: 10.2217/pmt-2018-0039. Epub 2018 Nov 5.

Intranasal ketamine for anesthetic premedication in children: a systematic review.

Author information

1
Department of Pediatrics, Schulich School of Medicine & Dentistry, London, Canada.
2
Division of Emergency Medicine, Western University, London, Canada.
3
Children's Health Research Institute, London Health Sciences Centre, London, Canada.
4
Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada.
5
Women & Children's Health Research Institute, University of Alberta, Edmonton, Canada.
6
Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, Edmonton, Canada.

Abstract

AIM:

In children, intravenous anesthetic premedication can be distressing. Intranasal (IN) ketamine offers a less invasive approach.

MATERIALS AND METHODS:

We included randomized trials of IN ketamine in anesthetic premedication in children 0-19 years. We performed electronic searches of MEDLINE, EMBASE, Google Scholar, CINAHL, Cochrane Library, Web of Science, Scopus, clinical trial registries and conference proceedings.

RESULTS:

Among the 23 trials (n = 1680) included, IN ketamine adequately sedated 220/311 (70%) for face mask application, 217/308 (70%) for caregiver separation, 200/371 (54%) for iv. insertion and 19/30 (63%) for monitor application. Vomiting was the most common adverse effect (35/1579 [2.2%]).

CONCLUSION:

There is a need for sufficiently powered, methodologically rigorous trials, using psychometrically evaluated, objective outcome measures to meaningfully inform practice.

KEYWORDS:

anesthetic; intranasal; ketamine; pain; pediatric; premedication

PMID:
30394192
DOI:
10.2217/pmt-2018-0039

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