Journal Jam 4 – Low Dose Ketamine Analgesia

You’d think ketamine was in the ED drinking water! Not only has this NMDA receptor antagonist been used effectively for procedural sedation and rapid sequence intubation, but also, for delayed sequence intubation to buy time for pre-oxygenation, for life-threatening asthma as it has bronchodilatory and anxiolytic effects, for severely agitated psychiatric patients and excited delirium syndrome to dissociate them and get them under control; ketamine has even been used for refractory status epilepticus and for head injured patients as it is thought to have neuroprotective effects. The big question is: How effective is low dose ketamine analgesia for patients with moderate to severe pain in the ED as an adjunct to opiods? Low dose ketamine seems not only to help control pain, but it also has this almost magical effect of making patients indifferent to the pain. Pain is everywhere. And oligoanalgesia occurs in up to 43% of patients in EDs. Can we relieve suffering with low dose ketamine analgesia in the ED?....