Archives of Craniofacial Surgery (대한두개안면성형외과학회지)

Korean Cleft Palate-Craniofacial Association (대한두개안면성형외과학회)
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Ketamine-induced generalized convulsive seizure during procedural sedation

  • Kim, Ji Hoon (Department of Plastic and Reconstructive Surgery, Bundang Jesaeng Hospital) ;
  • Lee, Chong Kun (Department of Plastic and Reconstructive Surgery, Bundang Jesaeng Hospital) ;
  • Yu, Sung Hoon (Department of Plastic and Reconstructive Surgery, Bundang Jesaeng Hospital) ;
  • Min, Byung Duk (Department of Plastic and Reconstructive Surgery, Bundang Jesaeng Hospital) ;
  • Chung, Chang Eun (Department of Plastic and Reconstructive Surgery, Bundang Jesaeng Hospital) ;
  • Kim, Dong Chul (Department of Plastic and Reconstructive Surgery, Bundang Jesaeng Hospital)
  • Received : 2021.03.22
  • Accepted : 2021.04.20
  • Published : 2021.04.20
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Abstract

Ketamine is used widely in emergency departments for a variety of purposes, including procedural sedation for facial laceration in pediatric patients. The major benefits are its rapid onset of effects, relatively short half-life, and lack of respiratory depression. The known side effects of ketamine are hallucinations, dizziness, nausea, and vomiting. Seizure is not a known side effect of ketamine in patients without a seizure history. Here, we present the case of a patient in whom ketamine likely induced a generalized tonic-clonic seizure when used as a single agent in procedural sedation for facial laceration repair. The aim of this article is to report a rare and unexpected side effect of ketamine used at the regular dose for procedural sedation. This novel case should be of interest to not only emergency physicians but also plastic surgeons.

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References

  1. Dorandeu F, Dhote F, Barbier L, Baccus B, Testylier G. Treatment of status epilepticus with ketamine, are we there yet? CNS Neurosci Ther 2013;19:411-27. https://doi.org/10.1111/cns.12096
  2. Zanos P, Moaddel R, Morris PJ, Riggs LM, Highland JN, Georgiou P, et al. Ketamine and ketamine metabolite pharmacology: insights into therapeutic mechanisms. Pharmacol Rev 2018;70:621-60. https://doi.org/10.1124/pr.117.015198
  3. Kurdi MS, Theerth KA, Deva RS. Ketamine: current applications in anesthesia, pain, and critical care. Anesth Essays Res 2014;8:283-90. https://doi.org/10.4103/0259-1162.143110
  4. Mion G, Villevieille T. Ketamine pharmacology: an update (pharmacodynamics and molecular aspects, recent findings). CNS Neurosci Ther 2013;19:370-80. https://doi.org/10.1111/cns.12099
  5. Meaden CW, Barnes S. Ketamine implicated in new onset seizure. Clin Pract Cases Emerg Med 2019;3:401-4. https://doi.org/10.5811/cpcem.2019.9.44271
  6. Borris DJ, Bertram EH, Kapur J. Ketamine controls prolonged status epilepticus. Epilepsy Res 2000;42:117-22. https://doi.org/10.1016/S0920-1211(00)00175-3
  7. Borsato GS, Siegel JL, Rose MQ, Ojard M, Feyissa AM, Quinones-Hinojosa A, et al. Ketamine in seizure management and future pharmacogenomic considerations. Pharmacogenomics J 2020;20:351-4. https://doi.org/10.1038/s41397-019-0120-2
  8. Modica PA, Tempelhoff R, White PF. Pro- and anticonvulsant effects of anesthetics (Part II). Anesth Analg 1990;70:433-44.
  9. White PF, Schuttler J, Shafer A, Stanski DR, Horai Y, Trevor AJ. Comparative pharmacology of the ketamine isomers: studies in volunteers. Br J Anaesth 1985;57:197-203. https://doi.org/10.1093/bja/57.2.197
  10. Toft P, Romer U. Comparison of midazolam and diazepam to supplement total intravenous anaesthesia with ketamine for endoscopy. Can J Anaesth 1987;34:466-9. https://doi.org/10.1007/BF03014351