Clinical Studies of Induction Agents Xxxvi: Ketamine

Interactive effects of subanesthetic ketamine and subhypnotic lorazepam in humans

“…Ketamine produced 1) positive symptoms of psychosis, such as illusions, disturbances in thought organization, and delusions; 2) negative symptoms similar to those associated with schizophrenia, including blunted emotional responses, emotional detachment, and psychomotor retardation; 3) perceptual alterations reminiscent of dissociative states, such as slowing of time perception, altered body perception, depersonalization, derealization, and distorted sensory perception; 4) impairments on tests of frontal cortical function including increased distractibility, reduced verbal ßuency, and poorer performance on the Wisconsin Card Sorting Test; and 5) learning impairments dependent on the dose of ketamine and the duration between stimulus presentation and testing. These ketamine responses are similar to the emergence phenomena associated with waking from ketamine anesthesia including perceptual alterations, vivid dreams, and delirium (Knox et al 1970;Collier 1972;White et al 1982) that limit its clinical anesthetic utility.…”

Management of a tumor in the distal trachea while maintaining spontaneous ventilation

“…It has been used extensively for emergency surgery in field conditions as early as the Vietnam War and as recently as the Haiti earthquake [4]. Nevertheless, its routine use is limited due to a number of significant side effects, mainly psychological, including hallucinations and postoperative delirium [5]. It usually stimulates the circulatory system, causing an increase in heart rate and blood pressure, and for this reason, it is sometimes used in anesthesia for emergency surgery when the patient's fluid volume status is unknown (e.g., from traffic accidents).…”

Ketamine for dilatation and curettage

“…Their figures also show that these disturbances are higher in the female, in fact two-thirds of the dreams were in females. Dundee et al 3,4 in their report of the use of ketamine in minor and major gynaecological procedures, found that one-third of all patients were disturbed to some extent when regaining consciousness and, in half of these, the upset was s(.w,re. They also showed that some of the premcdicant drugs could reduce the undesirable effects of ketamine, but they varied the dose of ketamine and it is not clear whether their figures with the diffcrcnt premedicants were all n&cs.…”