Use of Ketamine in Refractory Bronchospasm- A Study of 20 Cases
Journal Title: Journal of Krishna Institute of Medical Sciences University - Year 2013, Vol 2, Issue 2
Abstract
Objective: To study the effect of ketamine inpatients of severe wheezing due to bronchiolitiswho are refractory to the standard treatment.Methods: Prospective study including 104 childrenbetween 2 months to 2 years who presentedto us with severe wheezing due to bronchiolitis.Initially they were treated with humidifiedoxygen and adrenaline nebulisation. Childrenwith no response after 48 hours were givenintravenous ketamine as a bolus in dose of 1mg/kg. Patients were monitored with Uyanscore and oxygen saturation for 1 hour and thosewithout considerable improvement were givencontinuous infusion at 10 ìgm/kg/min. Results:104 patients were identified with severe wheezingdue to bronchiolitis during study period. 84(81%) patients responded well to standardtreatment. 20 (19%) patients who did not improvewere treated with ketamine. All patientsresponded to intravenous ketamine as bolus andshowed noticeable improvement in 1 hour withimprovement in scoring parameters. 14 (70%)patients had to be given infusion of ketamineand they were gradually weaned off the drip inan average of 15 hours. Conclusion: Use ofketamine in patients with severe wheezing dueto bronchiolitis who failed to respond to standardtreatment showed improvement which obviatedthe need for intubation and mechanicalventilation.
Authors and Affiliations
Vinayak Kshirsagar , Minhajuddin Ahmed , Sylvia Colaco
Keywords
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