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. 2018 Nov 1;8(6):495-503.
doi: 10.2217/pmt-2018-0039. Epub 2018 Nov 5.

Intranasal ketamine for anesthetic premedication in children: a systematic review

Naveen Poonai  1   2   3 , Kyle Canton  2 , Samina Ali  4   5 , Shawn Hendrikx  1 , Amit Shah  2 , Michael Miller  1   3 , Gary Joubert  1   2   3 , Lisa Hartling  6
Affiliations

Intranasal ketamine for anesthetic premedication in children: a systematic review

Naveen Poonai et al. Pain Manag. .

Abstract

Aim: In children, intravenous anesthetic premedication can be distressing. Intranasal (IN) ketamine offers a less invasive approach.

Materials and methods: We included randomized trials of IN ketamine in anesthetic premedication in children 0-19 years. We performed electronic searches of MEDLINE, EMBASE, Google Scholar, CINAHL, Cochrane Library, Web of Science, Scopus, clinical trial registries and conference proceedings.

Results: Among the 23 trials (n = 1680) included, IN ketamine adequately sedated 220/311 (70%) for face mask application, 217/308 (70%) for caregiver separation, 200/371 (54%) for iv. insertion and 19/30 (63%) for monitor application. Vomiting was the most common adverse effect (35/1579 [2.2%]).

Conclusion: There is a need for sufficiently powered, methodologically rigorous trials, using psychometrically evaluated, objective outcome measures to meaningfully inform practice.

Keywords: anesthetic; intranasal; ketamine; pain; pediatric; premedication.

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