Ventilatory Response during Dissociative Sedation in Children—A Pilot Study

OBJECTIVES: It is unclear whether ketamine induces subclinical respiratory depression when administered in dissociative doses intravenously (IV). The authors report a pilot study of capnography in emergency department (ED) pediatric patients receiving ketamine alone for procedural sedation, and describe serial measures of ventilatory response [end-tidal carbon dioxide (EtCO(2)), respiratory rate, pulse oximetry]. METHODS: The authors performed continuous capnography on a convenience sample of 20 ED pediatric patients who received ketamine 1.5 mg/kg IV for procedural sedation. RESULTS: Continuous EtCO(2) and pulse oximetry remained essentially unchanged following ketamine injection, and no EtCO(2) levels > 47 mm Hg were noted at any point throughout sedation. CONCLUSIONS: No hypoventilation was observed in 20 ED pediatric patients receiving ketamine 1.5 mg/kg administered IV over 1 minute. The authors found no evidence of respiratory depressant properties for this dissociative agent.