KETAMINE FOR LP IN CHILDREN?

Are there any studies on or protocols for the use of ketamine for sedation in children, specifically for lumbar puncture (LP)?
—Craig Holland, DO, Hemlock, Mich.

Ketamine is used in children to provide sedation for brief procedures, including laceration repair, LP, or fracture reduction. Administration is either via the IV route at a dose of 1.0-1.5 mg/kg over one to two minutes or the IM route at 4-5 mg/kg. Repeat doses can be given after 10 minutes at one-half the IV dose or the same IM dose. Side effects include decreased oxygen saturation, increased salivation, vomiting, and hallucinations, a rare complication in children. Contraindications include age younger than 3 months, airway instability, cardiopulmonary disease, head injury, glaucoma, thyroid disease, and psychosis.
— Michael E. Ryan, DO (109-17)

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