Volume 38, Issue 1 p. 60-64
Free Access

Rectal ketamine for induction of anaesthesia in children

Jan Idvall MD, PhD

Jan Idvall MD, PhD

Consultant Anaesthetist, Department of Anaesthesiology, Malmö General Hospital

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Jiri Holasek MD

Jiri Holasek MD

Consultant Anaesthetist, Department of Anaesthesiology, Värnamo Hospital, S-331 00

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Värnamo Pål Stenberg PharmD

Värnamo Pål Stenberg PharmD

Hospital Pharmacy, Malmö General Hospital, University cf Lund, S-214 01 Malmö, Sweden

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First published: January 1983
Citations: 31

Summary

Rectal premedication with atropine and diazepam and rectal induction of anaesthesia with ketamine have been used in 30 healthy children undergoing minor surgetv. The anticholinerigic and sedative effects of the premedication were satisfactory. Induction of anaesthesia was smooth with no adverse circulatory or respiratory effects. No psychotomimetic side-effects were seen, and analgesia persisted into the recovery period. Plasma concentrations of ketamine and norketamine were measured in eight childrer: and revealed a pharmacokinetic pattern indicating comparatively low bioavailability probably due to incomplete absorption from the rectum and a high ‘first-pass’ metabolism. The technique of rectal administration of ketamine needs further pharmacokinetic evaluation before it can be generally recommended.