Analysis of Intravenous Ketamine Bolus in Pediatric Emergency Care

Abstract

Considering the increasing use of intravenous ketamine in pediatric emergency care, particularly for sedation, analgesia, and management of severe conditions such as traumatic brain injury and suicidal ideation, there is a need to critically evaluate its efficacy and safety in these settings. This study aims to systematically review and analyze various studies that have investigated the use of intravenous ketamine bolus in pediatric emergency care, focusing on its clinical outcomes, safety profile, and overall effectiveness. To achieve this, a narrative literature review was conducted, examining studies published between 2014 and 2023. The review included randomized controlled trials, observational studies, and case reports sourced from reputable databases such as PubMed, Scopus, and Web of Science. The results of the review indicate that intravenous ketamine is effective in providing rapid sedation and analgesia, with a favorable safety profile when administered by trained healthcare professionals. Specifically, it was observed that ketamine significantly reduces pain intensity, lowers suicidal ideation, and effectively manages intracranial pressure in children with severe traumatic brain injury. However, the review also highlights the variability in recovery times and the incidence of mild to moderate side effects, such as dizziness, nausea, and drowsiness. In addition, the need for rescue doses was more frequent in intravenous administration compared to intramuscular routes, though intravenous administration offered quicker onset and shorter duration of action. It is concluded that while intravenous ketamine is a valuable tool in pediatric emergency care, its administration should be carefully monitored, particularly in high-risk patients, to mitigate potential adverse effects. Further research is needed to refine dosing strategies, explore long-term outcomes, and establish standardized protocols to maximize the therapeutic benefits of ketamine while minimizing risks.