Absolutely!
Regarding the use of benzodiazepines (midazolam, diazepam) with ketamine to
reduce hallucinations. In adults this could be considered and most of the
early studies were done in adults , but in children the incidence of
hallucinations is very small and there is no evidence that midazolam or
diazepam reduce it. In fact the evidence points towards the opposite
direction as it increases the incidence of O2 desaturation and agitation.
For more information I recommend to read the following two studies, both of
good quality and they concluded that in children , the concurrent use of
midazolam with ketamine is not justified
- Sherwin ST, Green SM, Khan A, Chapman S, Dannenberg B. Does adjunctive
midazolam reduce recovery agitation after ketamine sedation for pediatric
procedures? A randomised, double blind, placebo-controlled trial. Annals of
Emergency Medicine 2000; 35:229-238
- Wathen JE, Roback MG, Mackenzie T, Bothner J. Does midazolam alter the
effects of intravenous ketamine sedation in children?.A double blind,
randomised, controlled, emergency department trial. Annals of Emergency
Medicine 2000; 36:579-588
Andres Izquierdo Martin
SpR Emergency Medicine
North East Thames Region
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----- Original Message -----
From: <[log in to unmask]>
To: <[log in to unmask]>
Sent: Tuesday, February 13, 2001 11:51 AM
Subject: Ketamine
> Ketamine is a superb drug.
> I first used it in a rural African hospital, where it was used for most
surgical anaesthesia, and in outpatients for manipulations/minor ops etc.
> We didn't have advanced resus facilities, and they had never (in many
years) had a problem.
> Clearly however in the UK, we should only use such drugs with advanced
airway/resus training and with the appropriate facilities and assistance...
the point I'm making is merely that it is pretty safe.
> Hallucinations were rarely a problem either, with the concurrent use of iv
diazepam.
> Cheers!
> Giles.
>
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