Is there evidence that intranasal ketamine can provide adequate procedural sedation in paediatric patients?
For pediatric sedation needs, remember that IN ketamine is a useful fallback when IV access or needle aversion is a major barrier. However, do not rely on it as a first-line agent given its slightly lower success rate compared to IV options. Always discuss the risks and benefits transparently with parents to ensure shared decision-making before administering.
This review synthesized data from 150 papers to evaluate whether intranasal (IN) ketamine can adequately provide procedural sedation in the pediatric emergency department, comparing it directly to IV ketamine. The authors analyzed eight relevant studies and concluded that while IN ketamine is a viable needle-free alternative, its success rate appears slightly lower compared to the established efficacy of IV administration. Despite this comparative deficit, the review strongly suggests its utility for specific populations, particularly those children exhibiting severe phobia towards needles. Ultimately, the recommendation hinges on thorough parental counseling and shared decision-making processes.