Long-term use of an intravenous ketamine infusion in a child with significant burns

We report the use of an intravenous ketamine infusion for 37 days in a 9-year-old child with 42% body surface area burns. Ketamine was administered both in the intensive care unit and the surgical ward and provided high quality analgesia as an opioid adjunct. Throughout the long duration of administration, the child did not develop tolerance or experience psychomimetic side effects and weaning of the ketamine infusion was achieved rapidly, without evidence of withdrawal. This case demonstrates the safe and effective use of long-term intravenous ketamine in a child with significant burns on a surgical ward. We have focused the discussion on the issues of tolerance and weaning of long-term ketamine infusions in children.