Sedation and Analgesia for the Critically Ill Child: Ketamine

Abstract

Sedation and analgesia are essential components of the day-to-day management of critically ill pediatric patients. Ketamine, an N-methyl-d-aspartate (NMDA) receptor antagonist, has been used for decades for its sedative and analgesic properties. In the pediatric intensive care unit (PICU), ketamine has been used for a variety of indications, commonly for procedural sedation. At subanesthetic doses, ketamine is also used for acute and chronic pain management, often as an adjunct to opioid or as an opioid-sparing agent. This chapter will discuss the pharmacology, indications, dosing, and side effects of ketamine, relevant to its use in the PICU.