Korean J Anesthesiol.  2005 Jun;48(6):600-604. 10.4097/kjae.2005.48.6.600.

The Effect of Low-dose Ketamine on the Incidence of Emergence Agitation in Preschool Children Receiving Sevoflurane Anesthesia: Comparison with Ketorolac

• Park HH
• Cho HW
• Moon BK
• Park SY
• Kim JS
• Chae YJ

• KMID: 2238912
• DOI: http://doi.org/10.4097/kjae.2005.48.6.600

Abstract

BACKGROUND: Emergence agitation is a common side effect of sevoflurane anesthesia in preschool children. Low-dose ketamine is defined as a bolus dose of less than 1 mg/kg when administered via the intravenous route, and produces potent analgesia without respiratory depression or other side effects. In this study, we examined the effect of low-dose ketamine on the incidence of emergence agitation in preschool children receiving sevoflurane anesthesia and compared this with the effect of ketorolac.
METHODS
Sixty eight preschool children receiving sevoflurane anesthesia were randomized to receive either ketorolac 1 mg/kg or ketamine 0.2 mg/kg intravenously before the end of surgery. Emergence agitation was assessed using a 3-point scale (1 = asleep, calm, or mildly agitated but easily consolable; 2 = moderately agitated or restless but inconsolable; and 3 = hysterical, crying inconsolably, or thrashing) during transfer and at 10 minutes after arrival at our postanesthesia care unit.
RESULTS
We observed that the incidences of emergence agitation were 30.0%, 45.0% in the ketamine group, and 60.7%, 78.6% in the ketorolac group (P < 0.05) during transfer and at 10 minutes after arrival at the postanesthesia care unit, respectively. No significant difference was observed between the two groups with respect to discharge time from the postanethesia care unit.
CONCLUSIONS
Emergence agitation after sevoflurane anesthesia in preschool children was significantly reduced by low-dose ketamine as compared with ketorolac without delaying recovery.

Keyword

emergence agitation; ketamine; ketorolac; sevoflurane

MeSH Terms

Analgesia
Anesthesia*
Child, Preschool*
Crying
Dihydroergotamine*
Humans
Incidence*
Ketamine*
Ketorolac*
Respiratory Insufficiency
Dihydroergotamine
Ketamine
Ketorolac