We have found over and over again that it is very hard to get people to attend to follow up visits.
On the other hand, what dose of ketamine do you usually use? is it in a drip or PRN?
Great work!
Best
Fede
Hi Federico.
How glad to talk with you.
In my opinion, Ketamine titration is difiifult and its use shluld be as an perfussion adjuvant at 0'5 or 1 mg / kg / h.
Jesús
Hi Jesus! Happy to meet you again here!! We usually don´t use it as perfussion, only in boluses and we use 0,5 mg/kg PRN or for induction of anesthesia we use a maximum dose of 4 mg/kg. Having said that, in our experience it has proven to be a very good option both in unstable and stable patients, and we have had 3 patients with hard to manage pain (probably due to OIH) and the really improved with ketamine plus dex, and they were afterwards bridged to clonidine.
Fede
Ketamine plus dex, very promissing. Although this combination has not been considered in DeKaF trial, it seems.
Jesús
We need to explore even deeper on ketamines actions. It is a very interesting drug from the diferent targets it has. And its use is very scarce at least in Argentina mainly because of fear of psych complications.
The same occurs in Spanish ICUs. To avoid opiod treatment dependence in critical care, and knowing that pain is present in our patients, we should use more frequently this kind of sedatives with analgesic properties, as we do with alfa 2 agonists.
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