Ketamine use

Specialties CRNA

Published

Just wondering if any of you guys have any experience with ketamine as an anesthetic.

The reason I ask is b/c I was recently in a unit that was using it for a extremely agitated patient and it was working very well, but I haven't heard much about it except as a recreational---Special K. Isn't it used in Vet Med as a tranq. for large animals?

l used to work as anesth. asst RN in oral surg. one doc used it a lot....pt's held their airway great as opposed to Brevitol...never had any real problems with it but my exp was limited...l hear it is used as a date rape drug too....uhg!.......LR

you are right about veterinary med. ... but there are some great uses for it in human med, too...

pros: cardiovascular stimulant, minimal loss of respiratory drive, quick onset, if lucky great pain med

cons: unclear assoc w/ PONV, some patients go absolutely wacky

best memory about ketamine: patient attacking nurses in the unit, absolutely wild... snuck up from behind and hit him with full dose IM and then hid... he was down in 30 or so seconds :) and he was still breathing.

we used it on a patient who had a huge abd wound in an icu i did my nursing clinicals in. we called the crna's up to administer it but it really helped the pt deal with the dressing change.

Specializes in MS Home Health.

I know it is one of the drugs most stolen and sold on the black market.

renerian

Ketamine may be a good choice for CS in some children, especially when its difficult to get a line in; can be given IM, no respiratory or cv depression.

Not speaking as a nurse anaethetist but as one who worked in a high dependency setting.

We have used it a lot for post-op analgesia...became the anaesthetist's favourite drug for a while!! lol Either worked really well or not at all.

Can be very effective,,,but WOW do they have awesome dreams on that stuff:eek: Contributed a lot to post-op confusion in some patients.

It is good for mac cases, and pre-op of children. Combining with a benzo limits the side effects.

I might be way off here, but I thought ketamine had some kind of wierd psychotropic effect similar to LSD. It caused dissociation between the brain and the body.

Is this true?

Yes, hallucinations etc. that is where the benzo helps. You do not see the psychotropic effects when used in combination. (at least I have not seen it, and studies do bear that out)

I have used ketamine twice in the ER where I work part time and have really liked it. Mainly used it on little kids to repair large lacerations or ones that require precision on the face etc. They held their airway good, but they do have some pretty crazy dreams and they have some funky eye movements:):) It is true about the possible "LSD like" side effects but I never saw it.

Tia

Love to use ketamine, particularly in patients with significant heart disease. However, it can cause hallucinations, or what I like to call "in flight movies." Other than that, its also good to "dart" kids who are otherwise unmanagable.

Kevin McHugh

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