Reconciliation with ketamin!

Started by Alireza, June 06, 2007, 09:26:48 PM

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Alireza

 ;)I use ketamin in our hospital in many of surgeries in two method:I use atropin 0.5mg+midazolam 1mg+75-125mg nesdonal ,then support patient breaths for transient apnea,then i use anesthetic dose of ketamin in divided doses, every 1-2 min.
In second method i use ketofol ;):
1:1 ketamin and propofol in one syringe.yes,it is very interesting method for our surgeries.
I use this methods for varicocele,pilonidal cysts(in pron position),and other simple surgeries.
In tubal ligations that is common in our center,i use spinal anesthesia or one of above methods,plus suxamethonium before that surgeon enter the peritoneal cavity.
now:i don't use anesthetic gas,dint use LMA, dint intubate patient,have minimal side effect as emergence reaction.
I definitely consider contraindications of ketamin in my cases.

jafo1964

In India ketamine is practically used for every possible procedure. Starting from sub-anaesthetic doses to provide analgesia down to being the sole anaesthetic agent for diagnostic laproscopies of the pelvis.
Some use it along with narcotics
Along with Propofol called the PK regime it si gaining worldwide attention.
Need to remember that ketamine is not the answer to all anaesthetic troubles - it does not protect the airway, it is a mocardial depressant in catecholamine depleted patients and emergence delirium can cause problems.
The other worry is its abuse and addiction. In recent times it is the most smuggled drug from India for pleasure puposes. I fear that very soon it may be banned or difficult to procure owing to its abuse potential

yogenbhatt1

    Yes, a well exploited drug this Katamine is. Even in our regular use, standard sedation dose contains 25 mg Ketamine in addition to Medazolam and Pentazocine or  Fentanyl combination.
     It has a good analgesic property and above all it sort of dissociates the patient and reduces chances of awareness.
     At times even with spinal or Epidural, we add IV Ketamine as sedation along with other IV sedatives.
     I have used as mentioned a PK regime 50 mg in 20 ml of Propoflo with a syringe pump.
      Thanks for sharing the info with all of us.

corticalslices

ketamine may cause the neurotoxicity when used in the period of brain development. so I think that ketamine should not be used in clinical anesthesia today.

thachanesthetist

Quote from: corticalslices on June 28, 2007, 02:41:02 PM
so I think that ketamine should not be used in clinical anesthesia today.

I think Ketamine is still good analgesia agent in burn patients. However, I also want to know potential advers effects when Ketamine is infused for long time in burn patients.   

Alireza

thanks for ur ideas.but i dont  underestand mechanism of neurotoxicity of ketamin.if u have any references for it,plz explain for us.