Use of Ketamine in Refractory Bronchospasm- A Study of 20 Cases

摘要

Objective: To study the effect of ketamine inpatients of severe wheezing due to bronchioli-tis who are refractory to the standard treatment.Methods: Prospective study including 104 chil-dren between 2 months to 2 years who pre-sented to us with severe wheezing due to bron-chiolitis. Initially they were treated with humidi-fied oxygen and adrenaline nebulisation. Chil-dren with no response after 48 hours were givenintravenous ketamine as a bolus in dose of 1mg/kg. Patients were monitored with Uyanscore and oxygen saturation for 1 hour and thosewithout considerable improvement were givencontinuous infusion at 10 ìgm/kg/min. Results:104 patients were identified with severe wheez-ing due to bronchiolitis during study period. 84(81%) patients responded well to standardtreatment. 20 (19%) patients who did not im-prove were treated with ketamine. All patientsresponded to intravenous ketamine as bolus andshowed noticeable improvement in 1 hour withimprovement in scoring parameters. 14 (70%)patients had to be given infusion of ketamineand they were gradually weaned off the drip inan average of 15 hours. Conclusion: Use ofketamine in patients with severe wheezing dueto bronchiolitis who failed to respond to stan-dard treatment showed improvement which ob-viated the need for intubation and mechanicalventilation.