Ketamine for procedure

Q: Ketamine, when used as a sedative for procedures, doesn't need adjustment in renal or liver insufficiency?

A) True

B) False

Answer: A

Now ketamine is being frequently used for procedures particularly like intubations in ICU. Many of its characteristics which are favorable for procedures are:

• a trance-like state 
• sedation
• analgesia
• amnesia 
• preserve upper airway muscle tone and so airway protective reflexes
• preserve spontaneous breathing
• rapid onset
• short duration of effect (10 to 20 minutes)
• less hemodynamic effect
• No dose adjustments for impaired kidney or liver function

It should be remembered that Ketamine can exacerbate schizophrenia.

The dose for procedures in adults is 1 to 2 mg/kg intravenous over one to two minutes. Dose can be repeated every 5 to 10 minutes.

#procedures

#pharmacology

References:

1. Brown TB, Lovato LM, Parker D. Procedural sedation in the acute care setting. Am Fam Physician 2005; 71:85.

2. Baekgaard JS, Eskesen TG, Moo Lee J, Ikast Ottosen C, Bennett Gyldenkaerne K, Garoussian J, Ejlersgaard Christensen R, Sillesen M, King DR, Velmahos GC, Rasmussen LS, Steinmetz J. Ketamine for rapid sequence intubation in adult trauma patients: A retrospective observational study. Acta Anaesthesiol Scand. 2020 Oct;64(9):1234-1242. doi: 10.1111/aas.13651. Epub 2020 Jul 6. PMID: 32531068.