Abstract

The study objective was to prospectively evaluate the frequency and severity of behavioral reactions occurring in children receiving ketamine sedation in the emergency department (ED). A behavioral observational study was conducted. Ketamine was given in a standardized protocol with midazolam, atropine, and a prehypnotic suggestion. Descriptions of behavioral reactions were recorded immediately after the procedure, and longitudinal follow-up was made in 1 day, 1 week, and 1 month. A total of 301 patients were enrolled. Mild reactions described as not unpleasant occurred in 7/205 (3.4%, 95% CI 0.9-5.9%) of the younger age group, and 2/96 (2.1%, 95% CI 0-5.0%) of the older age group. Unpleasant reactions occurred in 2/205 (1.0%, 95% CI 0-2.4%) of the younger age group, and 4/96 (4.2%, 95% CI 0-8.2%) of the older age group. We observed no clinically important difference in the proportion of older versus younger children experiencing behavioral reactions after IV ketamine sedation. (Am J Emerg Med 2002;20:463-468. Copyright 2002, Elsevier Science (USA). All rights reserved.)

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