Table 2.
Ketamine administration parameters
| Author/ Year published | Latency to KE, median (range) | Previous ASMs/Anesthetics | KE dose, Median (Range) | KE duration, Median (Range) | Proportion of concurrent drug receiver/ drugs |
|---|---|---|---|---|---|
| Larger Case Series | |||||
| Gaspard 2013 | 9 d (6 h– 122 d) | PR, MDZ, PentB and TP |
LD- 1.5 mg/kg (maximum 5 mg/kg) MD- 2.75 mg/kg/h (0.05–10 mg/kg/h) |
4 d (6 h to 27 d) | 100%/ PentB, TP, MDZ and PR (2–12 drugs in every case) € |
| Sabharwal 2015 | NR | PR (in 61 patients) £ | MD- NR (1.5–10.5 mg/kg/h) | 5.97 d (1 d– 29 d) | 100%/ PR (25–140 mcg/kg/min) |
| Hofler 2016 | 3 d (2 d– 6.8 d) € | A median of two anesthetics and three antiepileptic drugs £ |
LD- 200 mg (200 mg to 250 mg) α MD- 2.39 mg/kg/h (1.52–3.02 mg/kg/h) |
4 d (2 d– 6.8 d) | 40%/PR |
| Alkhachroum2020 | 2 d (1 d − 4.5 d) ¥ | LEV, PHT, LCM, VPA, CLB, PB, GBP | MD- 2.2 mg/kg/h (0.2 mg/kg/h– 10 mg/kg/h) | 2 d (1 d– 4 d) | 100%/MDZ (100%), PR (53%), and PentB (14.7%) |
| Smaller Case Series | |||||
| Mewasingh 2003 | 28 d (14 d– 70 d) |
2 patients- MDZ and LZP, 3 patients - KE as 1st line of therapy. |
1.5 mg/kg/day (orally in two divided dose) | 5 d in all patients |
100%/ with maintenance ASMs (VPA, LTG, ETM, CZP, FBM, CLB, TPM) |
| Rosati 2012 | 6 d (2 d-26 d) | MDZ, TPH, and PR (N = 9,5 and 4 respectively) |
LD- NR (2–3 mg/kg, two boluses 5 min apart) MD- 2.4 mg/kg/h (0.6–3.6 mg/kg/h) |
6 d (3 d– 17 d) | 100%/ MDZ $, RUF, CZP, PB, STP, CLB, TPM, LZP, FBM, VPA, PHT, PR |
| Synowiec 2013 | 5 d (1 d– 11 d) | PR, LZP, PentB, MDZ, MDZ + PR (N = 7,1,1,1, and 1 respectively) |
LD- 1 mg/kg (N = 3) and 2 mg/kg (N = 7) MD- 1.3 mg/kg/h# (0.45–2.1 mg/kg/h) |
5 d (4 d − 28 d) | 100%/ PR, LZP, PentB, PB, VPA, PHT, CBZ, GBP, TPM, LEV, LTG, DZP, |
| Basha 2015 | 4 d (16 h– 11 d) | ≥ 1 IV anesthetics + ASMs (1–5 agents) |
LD- 1.1 mg/kg, 4.3 mg/kg, and 4 mg/kg (N = 2,1, and 1 respectively) MD- 4 mg/kg/h (1–5 mg/kg/h) |
3.5 d (2 d– 26 d) | 100%/ MDZ, PR, and PentB |
| Liaqat 2018 | NR | MDZ, PHT and LEV. |
LD- 5 mg/kg (N = 20) MD- 5 mg/kg/h (N = 20) |
NR | 60%/ TP and PR µ |
| Wang 2020 | 4 d (1.8 d − 6.3 d) | MDZ and PR in most cases£ |
LD- 1.5 mg/kg (0.3–1.6 mg/kg, N = 7) MD- 2.2 mg/kg/h (1.2–5.3 mg/kg/h, N = 18) |
4 d (2 d– 11 d) | 100%/ MDZ, PR, VPA, LEV, PB, Oxcarbazepine, CZP, TPM, NZP |
| Dericioglu 2020 | 6 d (4 d– 19 d) ¥ | LEV, CZP, TPM, oxcarbazepine, LCM, PHT, MDZ, PR |
LD- NR (0.5-2 mg/kg, N = 5) MD- NR (1–5 mg/kg/h) |
8 d (3 d − 24 d) | 86%/ MDZ (N = 4), PR (N = 2), TP (N = 1) |
| Caranzano 2022 | 4 d (2 d– 20 d) |
LEV, PR LCM, MDZ TP, TPM, PB, CBZ, FosPHT PGe, PP, CZP, CLB, |
MD- 5 mg/kg/h (2.5–15 mg/kg/h) | 2 d (1 d– 16 d) | 100%/ MDZ, PR, CZP, PHT, LEV, TPM, PG, PentB, VPA, LCM, |
| Case Report | |||||
| Hsieh 2010 | 58 d | DZP, VPA, MDZ, LEV, PHT, TPM, PR, TP |
LD- 0.5 mg/kg MD- 0.38 mg/kg/h |
5 days | 100%/ MDZ |
| Shrestha 2015 | 36 h and 42 h. | 1st case (LZP bolus, loading dose of PHT, Sodium VPA, LEV, PB, MDZ), 2nd case (MDZ bolus, PHT loading dose, Sodium VPA + LEV + CLB-Maintenance ASMS) |
LD- 1 mg/kg (50 mg and 35 mg) MD- 2 mg/kg/h (100 mg/h and 70 mg/h) |
3 d and 2 d | 100%/MDZ |
| Mutkule 2018 | 4 d | MDZ, LEV, LCM, PHT, CLB, VPA, PB, TPM, TP. |
LD- 1 mg/kg MD- 2 mg/kg/h |
7 d | None |
| Santoro 2019 | 9 d, 4 d, 32 d | MDZ, LEV, VPA, PHT, LZP, CLB, PB, LCM, DZP, GBP, ketogenic diet. | LD- 40 mg, 50 mg, and 40 mg MD- 3 mg/kg/h (N = 3) | 21 d, 21 d, and 14 d | 66%/PB, PHT or other ASMs |
| Samanta 2020 | 36 h and 30 h | 1st case (DZP, LZP, LEV, MDZ, CZP, VPA, oxcarbazepine, TPM), 2nd case (MDZ, IV LZP, fosPHT, LEV, LCM, PR) |
LD- 2 mg/kg in both MD- 0.5–2.5 and 3 mg/kg/h |
2 days and 1.5 days | None |
| Meenakshi-Sundaram 2020 | 3 d | IV LEV, LCM, MDZ infusion, TP, TPM, PB, CBZ, FosPHT, PP, CZP, CLB, Magnesium, Ketogenic diet |
LD- 3 mg/kg MD- 3 mg/kg/h |
30 d | 100%/Multiple ASMs and anesthetics |
| Manganotti 2021 | 12 d | IV PR, LEV, infusion of MDZ, VPA, PHT, LCM, |
LD- 3 mg/kg MD- 10 mg/kg/h |
3 d | 100%/PP |
Abbreviations IV- Intravenous; CBZ - carbamazepine; CLB - clobazam; CZP - clonazepam; ETM - ethosuximide; FBM - felbamate; KE - ketamine; LEV - levetiracetam; LTG - lamotrigine; LZP - lorazepam; MDZ - midazolam; NZP - nitrazepam; PB - phenobarbital; PentB- Pentobarbital; PHT - phenytoin; PR - propofol; RUF- rufinamide; STP - stiripentol; TP - thiopental; TPM - topiramate; VPA– valproate; LCM-lacosamide; GBP- gabapentin; PG-pregabalin; DZP-diazepam; Ox-CBZ-oxcarbarzepine; PP-perampanel; LD- Loading dose, MD- Maintenance dose; £ Mention of ASMs or anesthetics are not in detail; α administered only 7 out of 42 cases; ¥ After hospitalization; € Name of other drugs are not mentioned; $to control emergence reaction; #Mean; µ Anesthetics were used if seizure were not controlled within 24 h of KE infusion