Why the study?
Does rectal ketamine induction provide effective anaesthesia in healthy children undergoing minor surgery?
Does rectal ketamine induction provide effective anaesthesia in healthy children undergoing minor surgery?
Rectal ketamine for induction of anaesthesia in children provides smooth induction but has low bioavailability, requiring further pharmacokinetic evaluation before general recommendation.
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Smooth induction without adverse effects in this case; leaves open rectal ketamine bioavailability and suitability for pediatric use pending further study.
Rectal premedication with atropine and diazepam and rectal induction of anaesthesia with ketamine have been used in 30 healthy children undergoing minor surgetv. The anticholinerigic and sedative effects of the premedication were satisfactory. Induction of anaesthesia was smooth with no adverse circulatory or respiratory effects. No psychotomimetic side-effects were seen, and analgesia persisted into the recovery period. Plasma concentrations of ketamine and norketamine were measured in eight childrer: and revealed a pharmacokinetic pattern indicating comparatively low bioavailability probably due to incomplete absorption from the rectum and a high ‘first-pass’ metabolism. The technique of rectal administration of ketamine needs further pharmacokinetic evaluation before it can be generally recommended.
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Idvall et al. (1983) studied this question.
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