At 03:36 PM 5/12/00 +0000, you wrote:
Does anyone out there use ketamine ? Although included apparently on the
New Zealand hit list of "anaesthetic drugs" , it is in fact an incredibly
safe drug, used all over the world with a vanishingly small number of
serious complications, and allows manipulations, dressing changes etc to
proceed with total analgesia, and amnesia within 1 minute of
administration, while maintaining cardiac and respiratory function
intact. Scare stories of emergence phenomena are greatly exaggerated. I
usually have added a smidgen of midazolam just in case, though trials have
shown that this is not necessary. You can't overdose on it, but 0.5 - I
mg/kg slow IV injection always seems to do the trick, ( it can
occasionally apparently cause transient apnoea if IV pushed too hard).
It does not to have muscle relaxant properties, but on the occasions I
have used to for relocations ( on 2 hardened opiate + benzo-addicts with
genuine dislocations ) it overcame muscle spasm well.
The main problems with it is that we don't use it enough. I don' t have
experience myself of using it with children, but all colleagues who do
prefer it to messing around with opiates or benzos.
Paul Ransom
Perth,
Western Australia
>Delighted with comments generated on the list re propofol sedation in A&E.
>My literature search in FEb/March this year revealed only a case series report
>from the states of about 10 patients if I recall, Simon...sorry I dont have
>the reference to hand just now but if anyone is interested then you know how
>to contact me!
>
>I agree with the general feeling that it is not the agent that is the risk -
>it is the operator. Is it time for a policy statement from the faculty?
>Marten Howes
>SpR in A&E
>Blackpool
|