Association of ketamine with dexmedetomidine in pediatrics
Keywords:
Ketamine, Dexmedetomidine, Pediatric AnesthesiaAbstract
Objective: Invasive or prolonged pediatric procedures require safe, effective, and easily manageable sedation. The combination of ketamine and dexmedetomidine (Ketodex) provides sedative, analgesic, and anxiolytic effects, ensuring hemodynamic and respiratory stability while minimizing adverse events. This review analyzed studies published over the past five years. Ketodex proved effective in reducing anxiety, maintaining vital parameters, and improving patient comfort, although recovery time was longer compared with other drug combinations. In conclusion, Ketodex appears to be a safe and versatile alternative for various pediatric contexts, but further studies are needed to establish standardized protocols.
References
Mittal N, Goyal A, Gauba K, Kapur A. A double-blind randomized trial of ketofol versus propofol for endodontic treatment of anxious pediatric patients. J Clin Pediatr Dent. 2013;37(4):415-20.
Fischer S, Aboudara M, Coakley R, Fierro L, Zempsky W, Krane E, et al. Role of anxiety in young children’s pain memory development after surgery. Pain. 2019;160(5):965-72.
Gao PF, Xu QY, Li SY, et al. The comparison of ketamine-dexmedetomidine (ketadex) and ketamine-propofol (ketofol) for procedural sedation in pediatric patients: a meta-analysis of randomized controlled trials. Heliyon. 2022;8(10):e11166.
Lee S. Dexmedetomidine: present and future directions. Korean J Anesthesiol. 2019;72(4):323-30.
Tobias JD. Dexmedetomidine: applications in pediatric critical care and pediatric anesthesiology. Pediatr Crit Care Med. 2007;8(2):115-31.
Canet J, Raichle ME, Sessler DI. Ketamine: A familiar drug we trust. Anesthesiology. 2012;116(1):6-8
Peltoniemi MA, Hagelberg NM, Olkkola KT, Saari TI. Ketamine: a review of clinical pharmacokinetics and pharmacodynamics in anesthesia and pain therapy. Clin Pharmacokinet. 2016;55(9):1059-77.
Souza R, Pio D, Oliveira F. Sedação para exames e procedimentos fora do centro cirúrgico em crianças e adolescentes. Brasília: Ministério da Saúde; 2022.
Heath A, O’Brien S, McCormick B, Macfarlane F, Shukla U, Kotecha R, et al. The intranasal dexmedetomidine plus ketamine for procedural sedation in children (Ketodex): a statistical analysis plan. Trials. 2021;22:15..
Amer AM, Fathy GM, Hasan AM, Hamed BM, Khedr RM, Hussein AM. Propofol-ketamine versus dexmedetomidine-ketamine for sedation during upper gastrointestinal endoscopy in pediatric patients: a randomized clinical trial. Braz J Anesthesiol. 2020;70(6):620-6.
Cossovel F, Manfredini L, Di Maggio M, Lucchese A, Busetti M, Calligaris L, et al. Intranasal dexmedetomidine and intranasal ketamine association allows shorter induction time for pediatric sedation compared to intranasal dexmedetomidine and oral midazolam. Ital J Pediatr. 2022;48:5.
Haider K, Jain S, Sharma A, Jindal V, Gupta B. A double-blind randomized controlled trial to compare the safety and efficacy of dexmedetomidine alone and in combination with ketamine in uncooperative and anxious paediatric dental patients requiring pulpectomy. Eur Arch Paediatr Dent. 2022;23:465-73.
Qian B, Zheng W, Shi Y, Wang H, Wang J, Ma J, et al. Ketamine enhances intranasal dexmedetomidine-induced sedation in children: a randomized, double-blind trial. Drug Des Devel Ther. 2020;14:3559-65.
Li HP, Dai JM, Dai Y, Zhang F, Fang M, Zhang Y, et al. Dexmedetomidine in combination with ketamine for pediatric procedural sedation or premedication: a meta-analysis. Am J Emerg Med. 2021;50:442-8.
Shiferaw A, Aklilu A, Mekuria S. Evidence-based practical guideline for procedural pain management and sedation for burn pediatrics patients undergoing wound care procedures. Ann Med Surg. 2022;83:104756.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Revista de Divulgação Científica Sena Aires

This work is licensed under a Creative Commons Attribution 4.0 International License.
-
Atribuição — Você deve dar o crédito apropriado, prover um link para a licença e indicar se mudanças foram feitas. Você deve fazê-lo em qualquer circunstância razoável, mas de nenhuma maneira que sugira que o licenciante apoia você ou o seu uso.
- Sem restrições adicionais — Você não pode aplicar termos jurídicos ou medidas de caráter tecnológico que restrinjam legalmente outros de fazerem algo que a licença permita.
