Disease Control and Prevention. Ketamine is not an opioid, and frankly,
I think it controls pain better and has fewer side effects.
Can replace propofol. Ketamine is good for all patients, but
especially useful to induce anesthesia in patients who are not
candidates to receive propofol or other induction agents like metho-
hexital or etomidate. It's also not subject to shortage and therefore
readily available.
Sedates aggressive patients. Ketamine can be very useful in
pre-op. It comes in handy when I need to get an IV line in
patients who can be physically challenging, such as children, the men-
tally disabled or those who are aggressive. We once had a mentally
disabled, physically challenging teenage patient who was giving us a
tough time getting in a line. Sedating him using 5 mg/kg of ketamine
as an intra-muscular injection (what we refer to as a ketamine dart)
made it much easier.
Helps with post-operative pain. I also use ketamine to help with
post-op pain. All of our patients undergo relatively short proce-
dures, so a single bolus may be sufficient in the majority of cases.
When a case runs longer, we use that 0.2 to 0.3 mg/kg/hr infusion after
the bolus.
Opens the airways. Ketamine is a good bronchodilator. It opens
up the airways, which makes it a good choice for patients with
respiratory issues, like asthma and chronic obstructive pulmonary dis-
ease (COPD).
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