Author: John Carter
Effect of Ketamine on Cardiovascular Function During Procedural Sedation of Adults
Avoidance is recommended for patients with known coronary artery disease, older adults with risk factors for coronary artery disease, or those who are already hypertensive or tachycardic [1]. Ketamine is a useful medication in procedural sedation; however, careful attention should be made in patient selection when ketamine is the desired agent. Consideration might be made in using the lowest possible dose of ketamine to obtain adequate sedation in order to hopefully lessen the occurrence of ECG changes suggestive of myocardial ischemia.
The literature regarding the use of etomidate and ketamine for RSI in critically ill patients is reviewed and options for sedation during endotracheal intubation in this population are discussed. Prospectively, a convenience sample of patients older than 50 years receiving ketamine for procedural sedation in the ED was used. Recruitment occurred during hours when the three-person research team members were working clinically in the ED.
The study took place at an academic medical center with a level-one trauma designation that serves as a regional referral center for orthopedic injuries and other specialty care. It’s also used in palliative care and chronic cancer pain in the UK, in particular for individuals who are no longer responding to conventional opioid treatment. People who use it claim that a ketamine trip is superior to a PCP or LSD trip because it produces shorter-term hallucinations that last 30 minutes to an hour instead of several hours.
As a drug of abuse
Ketamine is included in the American Heart Association (AHA) list of medications that may cause or exacerbate heart failure and has been reported to precipitate myocardial ischemia in the elderly [2,3]. There is limited evidence of ketamine precipitating myocardial ischemia during short-term use in the emergency department (ED). Effects of administration of ketamine (Ket) for 12-weeks on sympathetic sprouting and distribution of nerve fibres. Growing evidence suggests that long-term abuse of ketamine does harm the heart and increases the risk of sudden death. The present study was performed to explore the cardiotoxicity of ketamine and the protective effects of metoprolol.
- Data sources include Micromedex (updated 3 Mar 2024), Cerner Multum™ (updated 4 Mar 2024), ASHP (updated 12 Feb 2024) and others.
- Ketamine’s ability to interfere with cardiovascular functions does come with considerable risks, one of which being cardiac arrest.
- All sedations had a nurse present for the sedation and a physician responsible for monitoring the patient separate from the procedural physician.
It’s also the case that tolerance to the drug can build up, meaning higher doses are required for a user to get the same effect, which can increase the risk of bladder damage. The Controlled Substance Act classifies ketamine as a Schedule III non-narcotic drug. Because of its pain-relieving and mental effects, it can cause dependence, the need to take higher doses to get the same effect, and addiction. No person with alcohol abuse disorder or alcohol intoxication should take ketamine, even in doctor-prescribed doses, as it can cause death.
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Patients were eligible for enrollment during each visit in the study period. Patients were excluded if they were pregnant, incarcerated, or unable to provide informed consent due to a language barrier or mental status. An initial goal of 50 patients was set, but following two years of recruitment, the study was closed to new subjects.
The drug is a Schedule III non-narcotic that the Food and Drug Administration (FDA) has approved for use only as a general anesthetic. However, doctors sometimes prescribe it for “off-label” uses, such as depression. Off-label means using the drugs to treat conditions the FDA has not approved. We do not receive any commission or fee that is dependent upon which treatment provider a caller chooses.
Glutamate chemical levels work to maintain a normal level of activity between the brain’s cells. This process enables the brain and body to communicate with one another on a continuous basis. Ketamine also causes individuals to have no memory of events that happen while they are under its influence. Due to this effect and its ability to sedate and incapacitate, some people use it as a date-rape drug.
Patients were selected to receive ketamine based on provider discretion. Patients were offered enrollment after sedation choice was made by the treating provider, and informed consent was obtained if patients agreed to enrollment. Ketamine was not required to be the sole agent used and could be administered with other sedating and analgesic agents.
Ketamine and alcohol
After 15–25 min, they recovered completely without any treatment, but looked tired. In addition, they nodded their heads rapidly and screamed occasionally. These reactions lasted for 1–3 min after injection, and full recovery required 15–25 min. Along with its needed effects, ketamine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Some people have an almost complete sensory detachment that they compare to a near-death experience. Keep reading to learn more about the uses, side effects, and risks of ketamine, as well as its interactions with alcohol and other drugs. While ketamine is safe to use in controlled medical practice, it becomes hazardous if someone takes it for recreational use as it may result in potentially life-threatening adverse effects. Ketamine’s effects on the heart can have long-term consequences for people who use this drug on a regular basis. According to the Journal of Advances in Clinical Toxicology, the brain’s inability to communicate with the cardiovascular system as normal takes a toll on the heart over time.
In spite of it’s reputation as a “date rape” drug, ketamine actually offers certain medical benefits as an surgical anesthetic agent. Since ketamine can be used for medicinal purposes, it’s classified as a Schedule III controlled substance rather one of the more dangerous Schedule I narcotics like heroin. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment.
Effect of Ketamine on Cardiovascular Function During Procedural Sedation of Adults
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What are the uses of ketamine?
Three rats (30%) in the ketamine group died at day 45, 50 and 52 of drug administration, while all rats survived through the entire procedure in the other three groups. Rats in the control and metoprolol alone groups gained weight steadily, while the ketamine-treated rats appeared to have thin, brittle and dull fur. In addition, they were emotionally unstable, more aggressive and easily became anxious. Ketamine-treated rats co-administered metoprolol were in a better state of nutrition and more stable emotionally than those treated only with ketamine. With chronic ketamine abuse, one or more of the above symptoms can escalate to the point where cardiac arrest occurs. There is some evidence that ketamine can be addictive to heavy users.