Nebulized ketamine for managing acute pain in the pediatric emergency department: A case series

Abstract

Administration of sub‐dissociative doses of ketamine is used via intranasal (IN) and intravenous routes in the pediatric emergency department for managing acute pain. Due to difficulties in both obtaining intravenous access and compliance with IN medications in children, administration of ketamine via breath‐actuated nebulizer can serve as a valuable modality for timely analgesia in children where dosing titration is patient controlled. We describe five pediatric patients who received ketamine via breath‐actuated nebulizer at 0.75 mg/kg, 1 mg/kg, and 1.5 mg/kg, with all patients experiencing a decrease in pain score. This case series introduces ketamine inhalation as a modality for managing pain in children.

This case series was approved by the hospital's, Maimonides Medical Center, institutional review board (IRB), and the ethical committee on May 9, 2019.

SM and JZ contributed to the conception and design of the work. AR, SM, and JZ took responsibility in the literature review. AR, MF, and JZ assisted in consenting and data collection/processing. All authors were involved with the organization/supervision of the article; contributed to the analysis of data, interpretation of the data, drafting/writing of the manuscript; and reviewed/approved the final version to be published.

None Declared.

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Everyone who contributed to this manuscript is an author, and there are no additional contributors that require acknowledgment.