Analgesic efficacy of ketamine in pediatric practice

Pain syndrome (PS) poses a serious challenge in children and adolescents admitted in ICUs. This review describes the outcomes of analgesic ketamine administration in pediatric patients with various PS. It discusses the advantages and disadvantages of this drug for pain relief in childhood. The mechanisms of analgesic effect through the effect on NMDA and opiate receptors are described. Pharmacokinetics of ketamine is described. The main dosages and routes of administration for PS relief in children and adolescents are indicated. The authors analyze clinical data on ketamine versus other analgesics for relief of intraoperative and postoperative pain, PS associated with cancer and chronic PS. Pediatric anesthesiologists should consider this analgesic for PS relief in children and adolescents.