[Prevention of psychedelic side effects associated with low dose continuous intravenous ketamine infusion].
OBJECTIVE
Continuous low dose infusion of intravenous ketamine for postoperative analgesia was often associated with frightening acute psychodysleptic experiences in our patients. We hypothesized they were due to boluses of ketamine accumulated in the infusion line. We evaluated on two successive groups the impact of perfusion line modifications on psychodysleptic side effects occurrence.


METHODS
We compared a reference historic group (in which ketamine line was connected to perfusion line) to a second prospective group (in which ketamine line was connected to the venous catheter via an unidirectional valve).


RESULTS
Psychodysleptic experiences occurrence decreased from 4 patients of 26 (15%) to 2 of 116 (2%, p = 0.01). Moreover, these experiences were no longer associated with severe anxious symptoms like near death experiences.


CONCLUSIONS
An unidirectional valve must be considered to limit the occurrence of low dose intravenous ketamine infusion associated psychedelic side effects, during postoperative analgesia.
Remerand
Francis
F
Groupement d'Anesthésie Réanimation, Hôpital Trousseau, CHU de Tours, Tours, France. fremerand@chu-tours.fr
Couvret
Claude
C
Pourrat
Xavier
X
Le Tendre
Charlotte
C
Baud
Annick
A
Fusciardi
Jacques
J
D000368:Aged; D000778:Anesthetics, Dissociative / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006212:Hallucinations / Q000139:chemically induced* / Q000517:prevention & control* / Q000523:psychology; D006801:Humans; D007262:Infusions, Intravenous; D007649:Ketamine / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy; D011446:Prospective Studies
D000778:Anesthetics, Dissociative; D007649:Ketamine