Low Dose Ketamine Infusion On The Floor Cardiac Monitoring

The patient monitor must have current credentials in.

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. See how another patient is using ketamine infusions to help with chronic neck pain how i ve been following up with the ketamine treatment. There is evidence that ketamine cardiovascular effects enhances the dysrhythmogenicity of epinephrine. To view a video presentation of the dose response to ketamine.

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. Patients receiving ketamine infusions with an average dose of 5 mcg kg per minute were identified through the pharmacy database. Ketamine induced a concentration dependent lengthening of the rr interval and slowed ventricular conduction and prolonged. 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.

On electroencephalogram eeg ketamine s effects are characterized by the abolition of alpha rhythm and the dominance of theta activity. 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. The effect of ketamine cardiovascular effects on cardiac rhythm is inconclusive. Low dose ketamine infusions must be prepared only by the pharmacy.

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. In the study by aya et al. 7 minute broadband video 340k. 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.

Clinical take home point. Patients prone to nausea with general anesthesia should receive a prophylactic 4 8 mg of zofran ondansetron p o. Electronic medical records in the institution were then cross referenced for cases in which patients treated with low dose ketamine infusions experienced adverse effects. 1 2 hour prior to the low dose ketamine infusion.

Motov s et al. 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.