Narcotics commonly used for postoperative analgesia may release histamine and cause bronchospasm in asthmatics. Ketamine, on the other hand, provides analgesia and has the additional advantage of preventing and relieving bronchospasm. We therefore delivered subanesthetic doses of ketamine in combination with midazolam (5.88-6.42 micrograms.kg-1.min-1 and 1.17-1.28 micrograms.kg-1.min-1, respectively), via an infusion for postoperative analgesia after elective abdominal hysterectomy in patients with asthma. Data were compared with those from a similar group of patients receiving conventional intramuscular meperidine. A significant degree and earlier onset of analgesia (P < 0.05) was achieved in the ketamine group. For other variables no significant difference was observed between the groups (P > 0.05). Ketamine-midazolam infusion can thus provide a safe alternative to the usual parenteral narcotic therapy in asthmatics, in terms of analgesia and patient acceptability.

A 19 yrs old male was admitted with upper abdominal pain and vomiting following ingestion of a fluid he thought to be beer. After repeated inquiry it was found that the clear fluid was “Fog Juice’’, used to produce artificial “Fog” or Smoke on the stage. After 36 hours of ingestion the patient developed severe respiratory distress & itching. Investigation reports confirmed Acute Renal Failure & Hyperkalaemia. He was sent to Nephrology Unit for dialysis, but the poor victim expired there about 48 hours after ingestion.DOI: http://dx.doi.org/10.3329/jom.v14i2.19687 J Medicine 2013, 14(2): 195-197