Intraocular Pressure Increases Are Trivial in Children During Ketamine Sedation

Investigators evaluated ketamine's effect on intraocular pressure in a prospective observational study of children aged 8–18 years undergoing procedural sedation at a pediatric emergency department. Tono-Pen measurements were taken before ketamine administration, immediately after, 2 minutes after, and every 5 minutes thereafter for up to 30 minutes. Children with a predisposition to elevations in intraocular pressure (e.g., diabetes mellitus, steroid use, history of previous eye surgery) were excluded.

Of 60 children who received ketamine (median cumulative dose, 1.5 mg/kg), the median increase in intraocular pressure was 3 mm Hg. Fifteen children (25%) had increases ≥5 mm Hg (the predefined threshold for a potentially clinically important …