Low-dose Intramuscular Ketamine for Anesthesia Pre-induction in Young Children Undergoing Brief Outpatient Procedures

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The authors sought to determine whether intramuscular ketamine (2 mg/kg) would facilitate inhaled induction of anesthesia in those children who are unccoperative. Thirty-five children were anesthtized with halothane and nitrous oxide for insertion of tympanotomy tubes. Twenty of those children were deemed by the anesthesiologist to be uncooperative and received 2 mg/kg of ketamine im prior to induction of anesthesia. The onset time (time from ketamine administration until induction of inhaled anesthesia could be started) was 2.7 ± 0.3 min. The quality of the subsequent acceptance of inhaled induction with halothane was excellent in 61% of the patients and adequate in the remaining 39%. The recovery and discharge times were compared with those observed in 15 matched children who accepted induction of anesthesia via a mask without the use of ketamine. Recovery time was not prolonged, but home discharge was delayed by an average of 13 min in the ketamine group (P < 0.04). Low-dose im ketamine was found to be an acceptable pre-induction drug in young children who are uncooperative for an inhaled induction of anesthesia.

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