Motov s et al.
Low dose ketamine infusion on the floor cardiac monitoring.
A patient specific order for a low dose ketamine infusion must be provided by and is restricted to acute pain service or anesthesiology.
1 2 hour prior to the low dose ketamine infusion.
To view a video presentation of the dose response to ketamine.
The effect of ketamine cardiovascular effects on cardiac rhythm is inconclusive.
Low dose ketamine infusion appears safe even without continuous hemodynamic monitoring despite the literature substantiating the use of low dose ketamine infusions in monitored settings the investigators realized that there is very little literature reviewing adverse events.
The patient monitor must have current credentials in.
Patients prone to nausea with general anesthesia should receive a prophylactic 4 8 mg of zofran ondansetron p o.
Guidelines have recently been approved 1 by the boards of directors at both the american society of regional anesthesia and pain medicine asra and the american academy of pain medicine.
Low dose ketamine should be infused through its own dedicated iv line when possible or via the most proximal port of a carrier solution.
There is evidence that ketamine cardiovascular effects enhances the dysrhythmogenicity of epinephrine.
Despite possessing a direct negative cardiac inotropic effect ketamine causes dose dependent direct stimulation of the cns that leads to increased sympathetic nervous system outflow.
Electronic medical records in the institution were then cross referenced for cases in which patients treated with low dose ketamine infusions experienced adverse effects.
Two weeks later i returned to the clinic for a 2 day ketamine booster infusion under the same protocol as before including a dose of magnesium in one of the infusion bags.
Low dose ketamine of 0 3mg kg mixed into 100ml of normal saline given over slow infusion 15 minutes has a decreased side effect i e hallucinations or dizziness and equal analgesic profile when compared to iv push 5 minutes low dose ketamine.
Patients receiving ketamine infusions with an average dose of 5 mcg kg per minute were identified through the pharmacy database.
In the study by aya et al.
Ketamine induced a concentration dependent lengthening of the rr interval and slowed ventricular conduction and prolonged.
Ketamine infusions have seen a recent surge in usage as a chronic pain treatment and thus a need for consensus guidelines for patient selection treatment parameters and monitoring was needed.
A qualified medical provider e g attending or resident physician mid level provider nurse practitioner np or physician assistant pa or registered nurse rn who observes assesses and documents the patient s response during ketamine administration.
7 minute broadband video 150k 7 minute dial up video 38k.
7 minute broadband video 340k.
Low dose ketamine infusions must be prepared only by the pharmacy.
