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tim simmonds
 Apr 17, 08 - 11:43 AM |
ketamine for acute pain
I have just returned from a study tour looking a pain management services in Perth Western Australia. Ketamine is used extensively for post op pain. However Fentanyl seems to be the primary opiate of choice for PCA followed by hydromorphone. Pts with ketamine infusions ( typically 0.1 mg per kg ) are cared for on normal wards ( larger percentage of side rooms, max up to 4 per bay). Main side effect hallucinations, bad dreams treated by reduction in dose or with a small dose of midazalam. Infusion often continued after discontunuation of pca in order to help wind down the patient ( I presume this is to counteract the effects of central sensitization ( wind up). Widely used for most major cases asl well as previous posts reasns ie neurapathic pain etc. Ketamine lozenges also used. |
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Charly
May 13th, 2008 - 2:09 PM |
Re: ketamine for acute pain
One of our trainees has just returned from Perth and is keen for us to trial Ketamine infusions. We currently run them at a low rate along side a morphine or fentanyl PCA. They are mostly nursed on our SHCU though we have had them on the wards. Most patients comment on some visual hallucinations, though none have been too distirbing. We have found it to be very effective. 
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