Ketamine sedation in gastrointestinal endoscopy in children

BACKGROUND: Moderate sedation for gastrointestinal endoscopy has traditionally been provided by the endoscopist. Controversy has ensued over safe and efficient sedation practice as endoscopy has increased in numbers and complexity. AIM: To evaluate the safety of ketamine sedation given by non-anesthesiologist during gastrointestinal endoscopy in children. METHODS: A prospective study of 100 paediatric patients with gastrointestinal symptoms who were a candidate for upper or lower gastrointestinal endoscopy in paediatric endoscopy unit at Abo El-Reesh paediatric hospital, Cairo university. All children were > 2 years old and weighed > 6 kg. The analysis was performed in terms of sedation-related complications. RESULTS: A total 100 paediatric patients including 53 males and 47 females with mean age of 5.04 years were involved in the study. All children were medicated with ketamine with a mean dose of 3.77mg/kg. No complications occurred in 87% of cases. Desaturation occurred in 13% of the cases and was reversible by supplemental nasal oxygen. Desaturation was more frequent during Upper GI Endoscopy and with the intramuscular route (p value=0.049). No apnea, bradycardia, arrest or emergence reactions were recorded. CONCLUSION: Ketamine sedation found to be safe for paediatric gastrointestinal endoscopy in Egyptian children without co-morbidities. Transient Hypoxia (13%) may occur but easily reversed by nasal oxygen therapy.