Although I agree with your concerns and would've opted not to use ketamine,
there is literature out there that it is safe...I think a group in Cincinnati
published something recently using ketamine for peritons. abscess IND!
Quoting Evan Mahl <[log in to unmask]>:
> Dear Group,
> The other night I had a 2 1/2 yo female who sustained
> a 1 cm lac to her lateral soft palate (running with a
> stick in the mouth). It was a bit gaping and oral
> surgery thought it should be closed.
> I was concerned about sedation for this child. I am a
> bit weary about sedating a child (with something like
> ketamine) who needs oral surgery. My only bad adverse
> event in the past was with a tongue lac/ketamine with
> bronchospasm. Perhaps a bit of fluid got on the cords
> and caused this spasm. I told the consult that i was
> uncomfortable with sedating this child without a
> protected airway (i.e. intubated in the OR) and she
> was sent out for follow-up on som pen-V-K.
> I am eager to know what thoughs people have about the
> appropriateness of procedural sedation in this
> patient. Were my concerns justified or just the
> jitters of a junior attending?
> Thank you,
> Evan Mahl, MD
> SUNY Downstate Medical Center
> Brooklyn, NY
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