----- Original Message -----
From: Gautam Ray <[log in to unmask]>
To: <[log in to unmask]>
Sent: 23 February 1999 21:14
Subject: Re: ketamine protocol
>>Does anyone have a ready made written protocol for the use of ketamine in
the
>>emergency department or in prehospital care?
>
>I asked about K recently, in the context of child sedation, and got some
>useful replies.
>Apart from the possible airway risk (doesn't seem to be a problem if
>proper dosing used), the thing that discourages us from trying it is the
>potential for delayed side-effects, like nightmares etc., over the next
>few nights after they've left the department. I couldn't find any
>evidence relating to this. Are there any lurkers from Lancaster or
>elsewhere with experience with Ketamine, who could tell me whether this
>is a real or merely a theoretical problem?
I've come across a couple of papers which might be of interest here:
1) Green SM et al., 'Intramuscular ketamine for pediatric sedation in the
emergency department: safety profile in 1,022 cases'; In Annals of Emergency
Medicine. 31(6):688-97 (June 1998)
Found that 17.6% of study group had 'mild recovery agitation' and that
'moderate to severe agitation' occurred in 1.6%. They also describe airway
complications in a minority of cases.
2) Bowdle TA et al., 'Psychadelic effects of ketamine in healthy volunteers:
relationship to steady-state plasma concentrations.'; In Anaesthesiology.
88(1):82-8 (January 1998).
Found a linear relationship between plasma conc. and psychedelic effects,
with sub-anaesthetic doses of ketamine. - Study group was small - 10
volunteers.
Hope this is of some interest.
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