Utilizzo della ketamina in Pronto Soccorso pediatrico

Background - Ketamine is widely recognised as a safe and effective drug for procedural analgesia and sedation in paediatric patients; however, its use in Italian paediatric emergency units remains heterogeneous. This report amis to describe the use of ketamine in a tertiary-level paediatric emergency unit, by analysing its indications, modalities of use and safety. Materials and Methods - A single-centre retrospective study conducted at the IRCCS ‘Burlo Garofolo’, including all ketamine administrations between January 2016 and November 2025. Patients aged 0-17 years were included. Demographic data, clinical indications, routes of administration, concomitant use with other drugs and adverse events were analysed. Results - A total of 680 administrations in 622 patients were assessed. The intravenous route was predominant (95%). The main indication was sedation for painful procedures (77%), followed by status epilepticus (9%), psychomotor agitation (8%) and sedation for non-painful procedures (6%). In 67% of cases, ketamine was used as a single sedative. Its use increased progressively over the years, reaching a peak of 66.2 doses per 10,000 visits in 2025, with a broadening of clinical indications. Mostly mild adverse events occurred in 8% of cases. One severe adverse event of laryngospasm - 0.15% - was recorded. Conclusions - The above-reported data support ketamine use by paediatric emergency physicians and suggest the importance of shared protocols to ensure appropriateness and safety.