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How long is everyone watching their patients who received IN ketamine?

Pam




Pamela S. Murphy, MD, FAAP

Mendy's Place, Children's Emergency Center
HonorHealth Deer Valley Medical Center

Lead Physician
Myelomeningocele Planning Clinic
Children's Rehabilitative Services, District Medical Group

On May 25, 2017, at 7:25 AM, Naveen Poonai <[log in to unmask]<mailto:[log in to unmask]>> wrote:

Our SR did not find dosing greater than 10 mg/kg. This is the dose we are using for our IN ketamine for fracture trial, slated to start this summer.


Naveen Poonai MSc MD FRCPC

Paediatric Emergency Physician, Children's Hospital, London Health Sciences Center

Associate Professor Paediatrics and Internal Medicine, Schulich School of Medicine & Dentistry

Associate Scientist, Child Health Research Institute

Research Director, Division of Paediatric Emergency Medicine

800 Commissioners Road East, Room E4-221, London, Ontario, N6A 5W9

Phone: 519 694 5309  Fax: 519 667 6769 Alternate email: [log in to unmask]<mailto:[log in to unmask]>

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________________________________
From: Robert Stewart <[log in to unmask]<mailto:[log in to unmask]>>
Sent: Wednesday, May 24, 2017 9:29 PM
To: Naveen Poonai
Cc: [log in to unmask]<mailto:[log in to unmask]>
Subject: Re: Intranasal Ketamine

I am also working on having intranasal ketamine available in our formulary. Does anyone have experience on MAX dose for intranasal dosing?




On May 24, 2017, at 8:59 AM, Naveen Poonai <[log in to unmask]<mailto:[log in to unmask]>> wrote:

We completed a systematic review on this topic. Sedation is inconsistent.  Onset and duration of sedation are quite variable so child needs extended monitoring. Effective sedation for laceration repair is at least 9 mg/kg.


Naveen Poonai, Kyle Canton, Samina Ali, Shawn Hendrikx, Amit Shah, Michael Miller, Gary Joubert , Michael Rieder, Lisa Hartling. Intranasal ketamine for procedural sedation and analgesia in children: a systematic review. PLoS One. 2017; 12(3):e0173253. DOI: 10.1371/journal.pone.0173253. PMID 28319161



Naveen Poonai MSc MD FRCPC

Paediatric Emergency Physician, Children's Hospital, London Health Sciences Center

Associate Professor Paediatrics and Internal Medicine, Schulich School of Medicine & Dentistry

Associate Scientist, Child Health Research Institute

Research Director, Division of Paediatric Emergency Medicine

800 Commissioners Road East, Room E4-221, London, Ontario, N6A 5W9

Phone: 519 694 5309  Fax: 519 667 6769 Alternate email: [log in to unmask]<mailto:[log in to unmask]>

[https://gwwa.lhsc.on.ca/gw/webacc?action=Get.Embedded.Image&User.context=c385f7cb5e8f8a64c844cada6503fe225ca8575&Embedded.Image.id=15033646d32a.mpf]


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________________________________
From: Pediatric Emergency Medicine Discussion List <[log in to unmask]<mailto:[log in to unmask]>> on behalf of Ali Ozcan <[log in to unmask]<mailto:[log in to unmask]>>
Sent: Wednesday, May 24, 2017 1:09 AM
To: [log in to unmask]<mailto:[log in to unmask]>
Subject: Intranasal Ketamine

Hi All,
We will start to use intranasal ketamine in our Pediatric Emergency for pain control and sedation. A couple of questions for the group:
Is anyone using it for simple laceration repairs, if so what is your dose?
What dose is usually adequate for 1. mild and 2. moderate sedation?
How long does it take for patients to recover after IN ketamine when it is given for 1. mild and 2. moderate sedation?

Thanks for your help! I'm happy to share the responses with anyone who is interested.


Ali Ozcan, PGY4
Pediatric Emergency Medicine
Beaumont Children's Hospital

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