PMID- 36217928
OWN - NLM
STAT- MEDLINE
DCOM- 20221012
LR  - 20230514
IS  - 2386-5857 (Electronic)
IS  - 1137-6821 (Linking)
VI  - 34
IP  - 5
DP  - 2022 Oct
TI  - Safety of ketamine for reducing fractures in a pediatric emergency department.
PG  - 339-344
AB  - OBJECTIVES: Ketamine is one of the most widely used drugs for analgesia and 
      sedation when reducing fractures in pediatric emergency departments (EDs). We 
      aimed to analyze the safety of intravenous (IV) ketamine when administered by 
      physicians who are not anesthesiologists. MATERIAL AND METHODS: Prospective 
      observational study of adverse events (AEs) related to pediatric ED specialists' 
      use of analgesia and sedation when reducing fractures in children under the age 
      of 14 years between 2011 and 2019. Multivariate analysis was used to identify 
      independent risk factors for AEs. RESULTS: We analyzed 1509 cases of IV ketamine 
      administration for analgesia and sedation. The median age of patients was 8 years 
      (interquartile range, 5-11 years). All had American Society of Anesthesiologists 
      risk classifications of 1 or 2 and Mallampati scores of I or II. Prior to the 
      procedure, 937 children (62.1%) had been administered an opioid analgesic. AEs 
      were observed in 201 children (13.3%; 95% CI, 11.7%-15.1%); 71 experienced 
      respiratory complications (4.7%; 95% CI, 3.2%-5.3%). No child required 
      intubation, other advanced resuscitation maneuvers, or hospital admission because 
      of a ketamine-related AE. Age was the only independent risk factor for developing 
      an AE. The odds ratio (OR) for any type of AE in children aged 8 years or older 
      was 1.9 (95% CI, 1.4-2.6). The OR for respiratory AEs in children aged 6 years or 
      older was 2.6 (95% CI, 1.3-5.6). Opioid administration did not increase risk for 
      AEs. CONCLUSION: Pediatric emergency physicians who are not anesthesiologists can 
      safely administer IV ketamine for reducing fractures. Prior use of opioids is not 
      associated with greater risk for respiratory AEs after ketamine use.
FAU - Olabarri, Mikel
AU  - Olabarri M
AD  - Servicio de Urgencias de Pediatria, Instituto de Investigacion Sanitaria 
      Biocruces Bizkaia, Hospital Universitario Cruces, Universidad del Pais Vasco, 
      Vizcaya, Espana.
FAU - Lejarzegi Anakabe, Elene
AU  - Lejarzegi Anakabe E
AD  - Servicio de Urgencias de Pediatria, Instituto de Investigacion Sanitaria 
      Biocruces Bizkaia, Hospital Universitario Cruces, Universidad del Pais Vasco, 
      Vizcaya, Espana.
FAU - Garcia, Silvia
AU  - Garcia S
AD  - Servicio de Urgencias de Pediatria, Instituto de Investigacion Sanitaria 
      Biocruces Bizkaia, Hospital Universitario Cruces, Universidad del Pais Vasco, 
      Vizcaya, Espana.
FAU - Intxauspe Maritxalar, Ane
AU  - Intxauspe Maritxalar A
AD  - Servicio de Urgencias de Pediatria, Instituto de Investigacion Sanitaria 
      Biocruces Bizkaia, Hospital Universitario Cruces, Universidad del Pais Vasco, 
      Vizcaya, Espana.
FAU - Benito, Javier
AU  - Benito J
AD  - Servicio de Urgencias de Pediatria, Instituto de Investigacion Sanitaria 
      Biocruces Bizkaia, Hospital Universitario Cruces, Universidad del Pais Vasco, 
      Vizcaya, Espana.
FAU - Mintegi, Santiago
AU  - Mintegi S
AD  - Servicio de Urgencias de Pediatria, Instituto de Investigacion Sanitaria 
      Biocruces Bizkaia, Hospital Universitario Cruces, Universidad del Pais Vasco, 
      Vizcaya, Espana.
LA  - eng
LA  - spa
PT  - Journal Article
TT  - Seguridad del uso de ketamina para reducir fracturas en un servicio de urgencias 
      pediatrico.
PL  - Spain
TA  - Emergencias
JT  - Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias
JID - 9805751
RN  - 0 (Analgesics, Opioid)
RN  - 690G0D6V8H (Ketamine)
SB  - IM
MH  - Analgesics, Opioid/adverse effects
MH  - Child
MH  - Child, Preschool
MH  - Conscious Sedation/adverse effects/methods
MH  - Emergency Service, Hospital
MH  - *Fractures, Bone
MH  - Humans
MH  - *Ketamine/adverse effects
OTO - NOTNLM
OT  - Emergency services, pediatric.
OT  - Fracturas.
OT  - Fracture reduction
OT  - Intravenous ketamine.
OT  - Ketamina intravenosa.
OT  - Servicio de urgencias pediatrico
EDAT- 2022/10/12 06:00
MHDA- 2022/10/13 06:00
CRDT- 2022/10/11 04:52
PHST- 2022/10/11 04:52 [entrez]
PHST- 2022/10/12 06:00 [pubmed]
PHST- 2022/10/13 06:00 [medline]
PST - ppublish
SO  - Emergencias. 2022 Oct;34(5):339-344.