Ketamine
Ketamine:
• Ketamine is a phenylpiperidine derivative
• It was designed to become the ideal anesthetic at a time when other anesthetics were quite toxic.
• It was popular in the Vietnam War.
• The anesthesia produced by ketamine is qualified as ‘dissociative’ for two reasons. First, the state of unconsciousness produced is quite different form that of the other anesthetics. The patient appears dissociated from his environment, not simply non-reactive. The second reason is given by EEG readings. Under ketamine, the electrical activity of the thalamus is no longer synchronized with the limbic system.
• Under ketamine, blood pressure is well maintained even in the case of hypovolemia.
• Breathing and laryngeal reflexes are preserved.
• Ketamine is highly effective against surgery- and opioid-induced hyperalgesia.
• Ketamine has anti-proinflammatory response that follows surgery.
• Dosage is 5-10 mg/kg IM. Many recommend that after the patient is sedated and an IV is started, versed should be given for amnesia and glycopyrrolate for secretions.
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