{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:42:46Z","timestamp":1787013766528,"version":"build-2736575974"},"reference-count":25,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2019,7,16]],"date-time":"2019-07-16T00:00:00Z","timestamp":1563235200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Guidelines issued by the American Society of Regional Anesthesia and Pain Medicine suggest that ketamine infusions for acute pain management are advantageous as a primary treatment or as an opioid adjunct. Despite significant data regarding its use in adult patients, there remains a paucity of information related to its quality and side effect profile in pediatrics and how it can be effectively used. We aimed to summarize our practice of utilizing ketamine for pediatric pain management in non\u2010critical care settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients aged 0\u201021 years receiving low\u2010dose ketamine infusions (\u22640.3 mg\/kg\/hour) in inpatient care units over five years were retrospectively analyzed. Demographics, specific quality metrics, and side effects were quantified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      About 172 patients received 270 subhypnotic ketamine infusions. The median duration of the infusions was 63.8 hours and 0.2 mg\/kg\/hour for the highest dose. The primary indication for ketamine was chronic pain exacerbation (83.3%). Despite similar opioid consumption, there was a significant reduction in mean verbal pain scores before (8.9 \u00b1 1.9,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001) and after ketamine (6.5 \u00b1 2.7,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001) use. Although there were 52 incidences of some side effect (neurologic excitability [10.4%]; over\u2010sedation [7.4%]; rapid response team alerts [1.1%]), none resulted in termination of the infusion or escalations in care.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Ketamine can effectively be used as part of a multimodal analgesic regimen in pediatric patients in non\u2010critical care settings. Our five\u2010year experience using low\u2010dose ketamine infusions highlights an acceptable side effect profile, with no attributable escalations in care or serious adverse events.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aas.13429","type":"journal-article","created":{"date-parts":[[2019,7,17]],"date-time":"2019-07-17T02:00:09Z","timestamp":1563328809000},"page":"1225-1230","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Subanesthetic ketamine infusions for the management of pediatric pain in non\u2010critical care settings: An observational analysis"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0063-5589","authenticated-orcid":false,"given":"Melissa M.","family":"Masaracchia","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Section of Pediatric Anesthesiology University of Colorado, Children\u2019s Hospital Colorado Aurora Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian D.","family":"Sites","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Dartmouth\u2010Hitchcock Medical Center Lebanon New Hampshire"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Lee","sequence":"additional","affiliation":[{"name":"University of Colorado School of Medicine Aurora Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James J.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Section of Pediatric Anesthesiology University of Colorado, Children\u2019s Hospital Colorado Aurora Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick G.","family":"Fernandez","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Section of Pediatric Anesthesiology University of Colorado, Children\u2019s Hospital Colorado Aurora Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,7,16]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e3181e90914"},{"issue":"5","key":"e_1_2_7_3_1","first-page":"456","article-title":"Consensus guidelines on the use of intravenous ketamine infusions for acute pain management from the American Society of Regional Anesthesia and Pain Medicine, the American Academy of Pain Medicine, and the American Society of Anesthesiologists","volume":"43","author":"Schwenk ES","year":"2018","journal-title":"Reg Anesth Pain Med"},{"issue":"5","key":"e_1_2_7_4_1","first-page":"521","article-title":"Consensus guidelines on the use of intravenous ketamine infusions for chronic pain from the American Society of Regional Anesthesia and Pain Medicine, the American Academy of Pain Medicine, and the American Society of Anesthesiologists","volume":"43","author":"Cohen SP","year":"2018","journal-title":"Reg Anesth Pain Med"},{"key":"e_1_2_7_5_1","volume-title":"Confronting the opioid crisis in the United States"},{"key":"e_1_2_7_6_1","unstructured":"The President\u2019s Commission on Combating Drug Addiction and the Opioid Crisis.ChristieC BakerC CooperR KennedyPJ MadrasB BondiP.https:\/\/www.whitehouse.gov\/sites\/whitehouse.gov\/files\/images\/Final_Report_Draft_11-1-2017.pdf. Published 2017. Accessed April 2019."},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j5790"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2015.04.012"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1213\/01.ANE.0000086618.28845.9B"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1213\/01.ANE.0000075837.67275.36"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200501000-00030"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2008.12.011"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000000920"},{"issue":"1","key":"e_1_2_7_14_1","first-page":"e31210","article-title":"The effect of administration of ketamine and paracetamol versus paracetamol singly on postoperative pain, nausea and vomiting after pediatric adenotonsillectomy","volume":"6","author":"Asadi HK","year":"2016","journal-title":"Anesth Pain Med"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/PEC.0000000000000978"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1515\/sjpain-2017-0140"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2010.03515.x"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S131156"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12887-015-0515-4"},{"issue":"3","key":"e_1_2_7_20_1","first-page":"e20172151","article-title":"AAP committee on practice and ambulatory medicine. Age limit of pediatrics","volume":"140","author":"Harden AP","year":"2017","journal-title":"Pediatrics"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2005.01773.x"},{"key":"e_1_2_7_22_1","volume-title":"Centers for Disease Control and Prevention","author":"Analyzing Prescription Data and Morphine Milligram Equivalents (MME)"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pedn.2017.01.006"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.12417"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2005.01476.x"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2008.02665.x"}],"container-title":["Acta Anaesthesiologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aas.13429","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aas.13429","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aas.13429","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T13:01:06Z","timestamp":1694091666000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/aas.13429"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,7,16]]},"references-count":25,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2019,10]]}},"alternative-id":["10.1111\/aas.13429"],"URL":"https:\/\/doi.org\/10.1111\/aas.13429","archive":["Portico"],"relation":{},"ISSN":["0001-5172","1399-6576"],"issn-type":[{"value":"0001-5172","type":"print"},{"value":"1399-6576","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,7,16]]},"assertion":[{"value":"2019-03-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-06-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-07-16","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}