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I have almost always been able to get my LP done using midazolam only. I
have not had to resort to stronger sedatives. I don't think I would use
ketamine unless no other options existed and it was a "must do" LP. 
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Pediatric Emergency Specialists, P.C.
Martin Herman, M.D.,FAAP,FACEP
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-----Original Message-----
From: Pediatric Emergency Medicine Discussion List
[mailto:[log in to unmask]] On Behalf Of Fatima Urooj
Sent: Sunday, February 10, 2008 4:11 AM
To: [log in to unmask]
Subject: Re: ketamine for LP in ER

Same question from group, perhaps very frequent requirement in ER is during
LP. But the issue of raised ICP still query???????

Dr Saeed Alobeidani <[log in to unmask]> wrote:  Just wondering if anybody
have experiences of using ketamine to preform LP
in emergency room in a child with suspected meningitis.
of-course there is the fear of raising the ICP, but is this clinically
significant?


I could find this study that address this qs:

J Child Neurol. 2006 Jun;21(6):441-3.
Ketamine increases opening cerebrospinal pressure in children undergoing
lumbar puncture.
Conc.:Intravenous ketamine prior to performing lumbar puncture is associated
with a significantly higher lumbar cerebrospinal fluid opening pressure in
children with aseptic meningitis. However, no outcome differences have been
found between the two groups.


S. Alobeidani,MD
PEM staff
Royal Hospital

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Dr.FATIMA UROOJ 
MBBS,MCPS,FCPS 
Senior Instructor, 
Section of Emergency medicine, 
Department of Medicine, 
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