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The FDA approved indication for Ketamine is as a sole anesthetic agent for diagnostic and surgical procedures.
Ketamine is a non-barbiturate anesthetic/analgesic agent structurally related to phencyclidine and cyclohexylamine. The drug is soluble in water and its lipid solubility is approximately 10 times that of thiopental. Ketamine has an intravenous onset within seconds and an elimination half-life of 2-3 hours.
Ketamine is the only single-agent anesthetic capable of producing a “dissociative” anesthesia, which has been useful for a variety of outpatient and inpatient surgical procedures. This agent also produces potent analgesia at subanesthetic, therapeutic concentrations. Ketamine generates dissociative anesthetic effects through direct action on the cortex and limbic system. It is believed that analgesic effects may be mediated by different mechanisms.
Ketamine is most effective for inducing and maintaining anesthesia in diagnostic and surgical procedures that do not require skeletal muscle relaxation; it is particularly useful for short procedures, in patients with bronchospasm, in those unable to receive barbiturates, and when cardiovascular depression must be avoided. Ketamine’s NMDA receptor blocking activity has shown some efficacy in terminating malignant status epilepticus, but data for this indication is limited.
Ketamine Intravenous infusion (IV) and Ketamine Intranasal (IN) treatments are used off-label for patients that suffer from addiction to drugs and alcohol, chronic and acute depression that is refractory to customary interventions, anxiety and panic attacks, posttraumatic stress disorder, obsessive-compulsive disorders, suicidal tendencies, unresolved post-surgical pain, prolonged recovery after operations or rehabilitation, various chronic pain syndromes, and nerve dysregulation syndromes such as CRPS and fibromyalgia.
At Loop Medical Center we use ketamine treatments for the following conditions: