{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T15:57:57Z","timestamp":1778860677136,"version":"3.51.4"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:sec>\n            <jats:title>Objective<\/jats:title>\n            <jats:p>Ketamine is a safe and widely used sedative and analgesic in children. The purpose of this study is to evaluate the response to sedoanalgesia for painful procedures in the pediatric emergency department.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>A retrospective study was conducted in children younger than 16 years who underwent painful procedures with intravenous\/intranasal ketamine between January 2016 and December 2022. We collected demographic variables, effectiveness, route of administration, indication, dose, sedation strategy, duration of procedure, and associated adverse effects.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>A total of 671 ketamine sedation procedures (411 males\/260 females) were included, with a mean age of 7.2 years. Closed reduction was the most common painful procedure (53.8%), followed by burn healing (24.6%). Ketamine was administered intravenously in 93.4% of procedures and intranasally in 6.6%. The result of sedoanalgesia was satisfactory in 84.9% and unsatisfactory in 15.1%. The percentage of cases with unsatisfactory analgesia was higher with intranasal administration (36.4%; <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001). In the intravenous group, the percentage of cases with unsatisfactory effectiveness (28.7%) was higher for patients younger than 2 years of age (<jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001). Arthrocentesis procedures were associated with the highest percentage of unsatisfactory sedoanalgesia failures among patients receiving intravenous ketamine (39.3%; <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001). Intranasal ketamine patients who received a dose between 3.6 and 4 mg\/kg had a significantly higher percentage of unsatisfactory sedoanalgesia (66.7%; <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.048). Patients receiving intravenous ketamine had significantly higher rates of unsatisfactory sedoanalgesia when the initial dose interval was 1.6 to 2 mg\/kg (11.8%; <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.002) and when the final total dose was also 1.6 to 2 mg\/kg (17.6%; <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.002).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>This study concludes that intravenous\/intranasal ketamine can provide safe and successful analgesia in pediatric patients in the ED. At intravenous doses of 1\u20131.5 mg\/kg, good effectiveness was achieved in almost 90% of cases. Arthrocentesis had the highest percentage of unsatisfactory results. Repeat dosing should be considered for procedures longer than 20 minutes.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/pec.0000000000003150","type":"journal-article","created":{"date-parts":[[2024,5,8]],"date-time":"2024-05-08T21:00:29Z","timestamp":1715202029000},"page":"654-659","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Sedoanalgesia With Ketamine in the Emergency Department"],"prefix":"10.1097","volume":"40","author":[{"given":"Miguel Angel","family":"Molina Guti\u00e9rrez","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda","family":"Fern\u00e1ndez Camu\u00f1as","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose Antonio","family":"Ru\u00edz Dom\u00ednguez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Bueno Barriocanal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bego\u00f1a","family":"De Miguel Lavisier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosario","family":"L\u00f3pez L\u00f3pez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda","family":"de Ceano-Vivas La Calle","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2024,5,9]]},"reference":[{"key":"bib1-20250504","doi-asserted-by":"crossref","first-page":"e1391","DOI":"10.1542\/peds.2012-2536","article-title":"Relief of pain and anxiety in pediatric patients in emergency medical systems","volume":"130","year":"2012","journal-title":"Pediatrics"},{"key":"bib3-20250504","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1097\/PEC.0000000000002580","article-title":"The clinical working group of Analgesia and Sedation of the Spanish Society for Pediatric Emergencies (SEUP). 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