Subdissociative Ketamine Use in the Emergency Department

Nichols, Kayla; Paciullo, Christopher

doi:10.1097/tme.0000000000000222

Cited by 13 publications

(6 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…reported a total of 590 Ketamine administrations, together with noting a high level of sedation efficacy, strong degrees of parental and staff satisfaction, and an adverse effect profile readily manageable by trained ED physicians. [ 10 11 12 ] However, the use of Ketamine can also lead to serious respiratory, cardiovascular and neuropsychiatric adverse events. This study was conducted to look for adverse effects related to the use of Ketamine in adult ED for PSA purposes.…”

Section: Discussionmentioning

confidence: 99%

The adverse effects of Ketamine on Procedural Sedation and Analgesia (PSA) in the Emergency Department

Dilip

Chandy

Hazra

et al. 2021

Journal of Family Medicine and Primary Care

View full text Add to dashboard Cite

Background: Procedural sedation and analgesia (PSA) in the emergency department (ED) is mainly used for wound irrigation, reduction of fractures, and wound closure. Ketamine is one of the most commonly used drugs for PSA in the ED. The study was conducted in the ED of a large tertiary care hospital in southern India to evaluate the adverse effects of Ketamine on PSA. Materials and Methods: This is a prospective observational study performed in the ED for 6 months (October 2019–March 2020) in 151 patients who required Ketamine for PSA. Titrated doses of Ketamine was administered in all patients; hemodynamic variables and adverse events were recorded at timed intervals. Results: During the study period, a total of 151 patients in the ED required PSA. The mean age of the study Cohort was 37 ± 15 years, and males accounted for 83%. All individuals obtained adequate sedation and pain relief. It was found that the incidence of adverse reactions to Ketamine was higher in young people (18- to 40-year-old), which was 63%. The most common adverse reaction in the study population was 39 cases of hypertension (44.8%), followed by vomiting in 25 cases (28.7%) and delusion in 6 cases (4%). There was no significant adverse effect in any patients which necessitated admission. Conclusion: Ketamine is a drug with good analgesic, sedative properties and has been shown to have a good safety profile with minimal adverse events for use as PSA in ED. Side effects were most common in the younger adult age group and hypertension was the most common side effect.

show abstract

Section: Discussionmentioning

confidence: 99%

The adverse effects of Ketamine on Procedural Sedation and Analgesia (PSA) in the Emergency Department

Dilip

Chandy

Hazra

et al. 2021

Journal of Family Medicine and Primary Care

View full text Add to dashboard Cite

show abstract

“…This results in a trancelike cataleptic state of sensory isolation, characterized by potent analgesia, sedation and amnesia while preserving cardiovascular stability and spontaneous respiration and protective airway reflexes. This unique dissociative action and the partial agonism on opiate mu-receptors permit the performance of painful procedures in a consistent state of sedation and patient comfort [52,53].…”

Section: Pharmacokinetics and Pharmacodynamicsmentioning

confidence: 99%

Procedural Sedation in Emergency Department: A Narrative Review

Cappellini,

Bavestrello Piccini,

Campagnola

et al. 2024

Preprint

View full text Add to dashboard Cite

Procedural Sedation and Analgesia (PSA) in the Emergency Department (ED) presents a crucial aspect of emergency medicine, enabling the execution of painful or distressing procedures with minimal patient discomfort. This narrative review delineates the pharmacological framework, methodologies, and clinical considerations integral to optimizing PSA, with a particular focus on pediatric and geriatric populations. Through a comprehensive review and analysis of current practices, this work evaluates the pharmacokinetics and pharmacodynamics of widely utilized sedatives and analgesics, including propofol, ketamine, dexmedetomidine, fentanyl, midazolam, etomidate, nitrous oxide, and remimazolam. Special attention is dedicated to the selection criteria based on patient-specific risk factors, procedural requirements, and the management of potential adverse effects. The manuscript also explores innovative sedation techniques and the integration of new pharmacological agents, emphasizing evidence-based approaches to enhance patient safety and outcome. Results underscore the significance of tailored sedation strategies, especially for vulnerable groups such as pediatric and geriatric patients, highlighting the need for meticulous pre-procedural assessment and monitoring to mitigate risks. Conclusions drawn advocate for a nuanced application of PSA, guided by current evidence and clinical guidelines, to improve the quality of care in emergency settings. This research reinforces the imperative for ongoing education, skill development, and adaptation of new evidence into clinical practice to advance procedural sedation and analgesia in the ED.

show abstract

“…This results in a trance-like state of sensory isolation where patients experience significant analgesia, sedation, and amnesia and yet maintain cardiovascular stability as well as spontaneous breathing and protective airway reflexes. Its unique dissociative properties and partial agonism at opiate mu-receptors allow for the conduct of painful procedures with consistent sedation and patient comfort [49,50]. Additionally, ketamine interacts with sigma receptors and can reduce central sensitization, the wind-up phenomenon, and the memory of pain, making it useful in managing ongoing or chronic pain [47].…”

Section: Pharmacokinetics and Pharmacodynamicsmentioning

confidence: 99%

Procedural Sedation in Emergency Department: A Narrative Review

Cappellini,

Bavestrello Piccini,

Campagnola

et al. 2024

Emergency Care and Medicine

View full text Add to dashboard Cite

Procedural sedation and analgesia (PSA) in the emergency department (ED) presents a crucial aspect of emergency medicine, enabling the execution of painful or distressing procedures with minimal patient discomfort. This narrative review delineates the pharmacological framework, methodologies, and clinical considerations integral to optimizing PSA, with a particular focus on pediatric and geriatric populations. Through a comprehensive review and analysis of current practices, this work evaluates the pharmacokinetics and pharmacodynamics of widely utilized sedatives and analgesics, including propofol, ketamine, dexmedetomidine, fentanyl, midazolam, etomidate, nitrous oxide, and remimazolam. Special attention is dedicated to the selection criteria based on patient-specific risk factors, procedural requirements, and the management of potential adverse effects. The manuscript also explores innovative sedation techniques and the integration of new pharmacological agents, emphasizing evidence-based approaches to enhance patient safety and outcome. The results underscore the significance of tailored sedation strategies, especially for vulnerable groups such as pediatric and geriatric patients, highlighting the need for meticulous pre-procedural assessment and monitoring to mitigate risks. The conclusions drawn advocate for a nuanced application of PSA, guided by current evidence and clinical guidelines, to improve the quality of care in emergency settings. This research reinforces the imperative for ongoing education, skill development, and the adaptation of new evidence into clinical practice to advance procedural sedation and analgesia in the ED.

show abstract

Subdissociative Ketamine Use in the Emergency Department

Cited by 13 publications

References 31 publications

The adverse effects of Ketamine on Procedural Sedation and Analgesia (PSA) in the Emergency Department

The adverse effects of Ketamine on Procedural Sedation and Analgesia (PSA) in the Emergency Department

Procedural Sedation in Emergency Department: A Narrative Review

Procedural Sedation in Emergency Department: A Narrative Review

Contact Info

Product

Resources

About