Document Detail


Radiologist-supervised ketamine sedation for solid organ biopsies in children and adolescents.
MedLine Citation:
PMID:  19380549     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Pediatric interventional radiologists are frequently challenged when faced with organ biopsies. Because of the need for patient immobility and the potential risk of morbidity with patient movement during biopsies, many radiologists prefer general anesthesia to sedation. We present our experience with radiologist-supervised ketamine sedation in pediatric patients undergoing renal and hepatic biopsies. MATERIALS AND METHODS: Quality assurance data were accessed from a computerized database that prospectively collects demographics, outcome parameters, and adverse events on all patients who receive ketamine sedation. Patients received an IV ketamine bolus of 2 mg/kg followed by a continuous infusion of ketamine of up to 150 mcg/kg/min titrated to the responsiveness of the patient. RESULTS: Sixty-five children received ketamine for liver (n = 35) and renal (n = 30) biopsies. The mean age of the study group was 7.0 +/- 2.7 (SD) years. The cohort included patients with an American Society of Anesthesiologists (ASA) physical status classification of ASA 1 (3%), ASA 2 (78%), and ASA 3 (19%). The duration of ketamine sedation averaged 39 +/- 20 (SD) minutes, with an average procedure time of 32 +/- 19 (SD) minutes. All procedures were successfully completed, and there were no major adverse events. CONCLUSION: Interventional radiologists performing solid organ biopsies in the pediatric population often use general anesthesia to ensure immobility, adequate analgesia, and safe conditions. Our experience suggests that interventional radiologists may supervise a nurse-administered ketamine protocol to provide safe, effective analgesia and sedation for liver and renal biopsies.
Authors:
Keira P Mason; Horacio Padua; Paulette J Fontaine; David Zurakowski
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  AJR. American journal of roentgenology     Volume:  192     ISSN:  1546-3141     ISO Abbreviation:  AJR Am J Roentgenol     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-04-21     Completed Date:  2009-05-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7708173     Medline TA:  AJR Am J Roentgenol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1261-5     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesia, Children's Hospital Boston, 300 Longwood Ave., Boston, MA 02115, USA. keira.mason@childrens.harvard.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Anesthetics, Dissociative / administration & dosage*
Biopsy*
Child
Child, Preschool
Confidence Intervals
Female
Humans
Infant
Ketamine / administration & dosage*
Kidney Diseases / pathology*
Liver Diseases / pathology*
Male
Retrospective Studies
Ultrasonography, Interventional*
Chemical
Reg. No./Substance:
0/Anesthetics, Dissociative; 6740-88-1/Ketamine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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