Ketamine Induced Seizures

摘要

10 year old, 25 kg boy posted for tonsillectomy had no past history of convulsions to him or any other of his family member. He was administered Inj. Ketamine 100mg along with Inj. Glycopylorrate 0.2mg IM pre-operatively in pre-op room as premedication. In less than 5minutes patient developed Generalized tonic and clonic seizures. His airway was maintained along with oxygen supplementation and IV line secured to administered Inj. Midazolam 1mg IV bolus. Seizures abolished and Endotracheal intubation was done. Intraoperative and Post operative course including extubation was uneventful. Ketamine has been implicated as having proconvulsant as well as anti-convulsant activity. Our experience prompted us to believe that ketamine may not be a safe drug as premedication outside Operation theatre and an alternative anesthetic drug may be considered.Seizures in the perioperative period can be due to a number of factors. Various clinical reports described both proconvulsant and anticonvulsant properties for many anesthetic agents. We report a case of perioperative Generalised Tonic Clonic seizure with the use of intramuscular ketamine given as premedication in a case of tonsillectomy.