[P1-107] Ketamine-induced generalized tonic-clonic seizure
Background: Ketamine hydrochloride, a dissociative anesthetic, appears to induce both excitatory and depressant actions in the brain. Intravenous/intramuscular ketamine may cause seizures in the hippocampus. We report a case of preoperative generalized tonic-clonic seizure with the use of intramuscular ketamine given as premedication for reduction of forearm fracture.
Case: A 5 year old girl visited at our Hospital Emergency Department with forearm fracture. The vital signs were body temperature of 36.5℃, pulse rate of 113 beats/min, and blood pressure of 100/65 mmHg. She has no past history and no her family history of convulsions. She was not given any preoperative antibiotics. She was alert, with no other abnormal neurological findings. She was administered intramuscular ketamine 85 mg (3.4 mg/kg) injection as premedication for reduction of forearm facture in emergency operation room. About 5 minutes after ketamine injection, patient developed generalized tonic-clonic seizure and O2 saturation was 50%. Immediately oxygen supplementation with face mask was done. Seizure lasted approximately 5 minutes, and then, her mental state was drowsy. Patient was kept in emergency room for 12 hours with no other problems. On the day after event, MRI and EEG were performed, these results were normal.
Conclusion: Ketamine can induce seizures. This case report prompted us to believe that ketamine may not be a safe drug as premedication. We suggest that the administering ketamine as premedication need for caution even in healthy individual.
Case: A 5 year old girl visited at our Hospital Emergency Department with forearm fracture. The vital signs were body temperature of 36.5℃, pulse rate of 113 beats/min, and blood pressure of 100/65 mmHg. She has no past history and no her family history of convulsions. She was not given any preoperative antibiotics. She was alert, with no other abnormal neurological findings. She was administered intramuscular ketamine 85 mg (3.4 mg/kg) injection as premedication for reduction of forearm facture in emergency operation room. About 5 minutes after ketamine injection, patient developed generalized tonic-clonic seizure and O2 saturation was 50%. Immediately oxygen supplementation with face mask was done. Seizure lasted approximately 5 minutes, and then, her mental state was drowsy. Patient was kept in emergency room for 12 hours with no other problems. On the day after event, MRI and EEG were performed, these results were normal.
Conclusion: Ketamine can induce seizures. This case report prompted us to believe that ketamine may not be a safe drug as premedication. We suggest that the administering ketamine as premedication need for caution even in healthy individual.