Royal Lancaster Infirmary www.NHS.uk
Accident & Emergency Department
Current projects: Ketamine

This department has been heavily involved in re-introducing the use of Ketamine for sedation of children to allow painful procedures in the UK.

Ketamine is a dissociative anaesthetic, that is, the child remains awake but is unaware of their surroundings. This in turn allows the use of local anaesthetic and then suturing, nail bed, finger tip repair or wound cleaning.

Published research fromthis department has shown the safety and acceptability of this treatment for parent, patient and staff.

Further information regarding the use of Ketamine can be found in the following reference.

An alternative to "Brutacaine": a comparison of low dose intramuscular ketamine with intranasal midazolam in children before suturing.
McGlone R, Ranasinghe S, Durham S. J Accid Emerg Med 1998;15:231-236

The following pictures show two examples of the effect that Ketamine has on children. The pictures shown pre the dose of Ketamine has been administered are of the children prior to suturing:

Pre KetaminePost Ketamine
Pre Ketamine Child 1 Post Ketamine Child 1
Pre Ketamine Child 2 Post Ketamine Child 2

Further work is underway using lower dose Ketamine to lower the side effect protocol further. Protocols are available on request.

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