Long term high dose morphine, ketamine and midazolam infusion in a child with burns.

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Abstract
The metabolism of morphine and ketamine was studied in a 14 month old child with extensive burns, who received infusions of both drugs for more than 30 days. The mean plasma clearance of morphine was 29 ml min‐ 1 kg‐1 and the plasma ratios of morphine‐6‐glucuronide to morphine were similar to those previously reported in children. The mean plasma clearance of ketamine was 32 ml min‐1 kg‐1 which is greater than that previously reported in older children and adults. There were no complications despite high dose long term therapy with morphine, ketamine and midazolam.