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Pain management
Ketamine used for postoperative pain management. Low doses of ketamine may reduce morphine use, nausea, and vomiting after surgery.
Ketamine has similar efficacy to opioids in a hospital emergency department setting for management of acute pain and for control of procedural pain.
It may also be used as an intravenous analgesic with opiates to manage otherwise intractable pain, particularly if this pain is neuropathic. It has the added benefit of counteracting spinal sensitization or wind-up phenomena experienced with chronic pain. At these doses, the psychotropic side effects are less apparent and well managed with benzodiazepines. Ketamine is an analgesic that is most effective when used alongside a low-dose opioid; while it does have analgesic effects by itself, the doses required for adequate pain relief when used as the sole analgesic agent are considerably higher and far more likely to produce disorienting side effects. A review article in 2013 concluded, “despite limitations in the breadth and depth of data available, there is evidence that ketamine may be a viable option for treatment-refractory cancer pain”.Order Ketamine Online
Low-dose ketamine used in the treatment of complex regional pain syndrome (CRPS). A 2013 systematic review found only low-quality evidence to support the use of ketamine for CRPS
Anesthesia
Uses as an anesthetic:
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Anesthesia in children, as the sole anesthetic for minor procedures or as an induction agent followed by muscle relaxant and tracheal intubation
Asthmatics or people with chronic obstructive airway disease
As a sedative for physically painful procedures in emergency departments
Emergency surgery in field conditions in war zones
To supplement spinal or epidural anesthesia/analgesia using low doses
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Ketamine is frequently used in severely injured people and appears to be safe in this group. Firstly, a 2011 clinical practice guideline supports the use of ketamine as a dissociative sedative in emergency medicine. Moreover, it is the drug of choice for people in traumatic shock who are at risk of hypotension. Low blood pressure is however harmful in people with severe head injury and ketamine is least likely to cause low blood pressure, often even able to prevent it.
The effect of ketamine on the respiratory and circulatory systems is different from that of other anesthetics. However, when used at anesthetic doses, it usually stimulates rather than depress the circulatory system. It is sometimes possible to perform ketamine anesthesia without protective measures to the airways. In conclusion Ketamine is safe since protective airway reflexes are preserved.
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