Intravenous Ketamine as an Adjunct to Procedural Sedation During Burn Wound Care and Dressing Changes
| Autor: | Kaitlin McGinn, A Lintner, James K Landry, Steven A Kahn, Phillip G Brennan, M Victoria P Miles |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.drug_class Midazolam Sedation Conscious Sedation 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Interquartile range medicine Humans Hypnotics and Sedatives Pain Management Ketamine Infusions Intravenous Adverse effect Pain Measurement Retrospective Studies Analgesics business.industry Rehabilitation 030208 emergency & critical care medicine Burn center Retrospective cohort study Middle Aged Bandages Analgesics Opioid Anesthesia Sedative Emergency Medicine Female Surgery medicine.symptom Burns business medicine.drug |
| Zdroj: | Journal of Burn Care & Research. 40:246-250 |
| ISSN: | 1559-0488 1559-047X |
| DOI: | 10.1093/jbcr/iry044 |
| Popis: | Little has been published regarding intravenous (IV) ketamine for burn wound care in adult patients. Ketamine may serve as a safe alternative to provide conscious sedation and limit opioid administration to patients. The purpose of this study was to characterize IV ketamine use during burn wound care and establish its potential role as a safe adjunct to opioid and benzodiazepine medications. This is a retrospective review of adult patients admitted to a regional burn center who received IV ketamine for burn wound care. Patient demographics, medications, and ketamine-related adverse effects including hypertension and dysphoric reactions were recorded. Cardiopulmonary complications were also tracked. Thirty-six patients met inclusion criteria; fifty total cases were performed. The median patient age was 37 (interquartile range [IQR]: 28-55] years with a median burn size of 9.5 (IQR: 4.0-52) %TBSA. The median ketamine dose administered was 1.2 (IQR: 0.8-2.1) mg/kg. IV midazolam was administered in almost all cases (98%) at a median dose of 3.0 (IQR: 2.0-5.0) mg. Opioids were administered in 13 of 50 cases (26%) at a median morphine equivalent dose of 10 (IQR: 5.0-18) mg. In 46 cases (92%), patients denied unpleasant recall of medication. Dysphoric reactions were observed in three cases (6%). Ketamine-induced hypertension occurred in three cases (6%) and all immediately responded to IV labetalol. There were no cardiopulmonary complications. These findings suggest that IV ketamine provides a safe analgesia and sedative option for burn wound care. Given these findings, IV ketamine for burn wound care warrants further study. |
| Databáze: | OpenAIRE |
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