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  1. #1
    Join Date
    Oct 2014
    The Netherlands

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    Default Esketamine works (or am I imagining things?)

    I've started using more ketamine for my patients. Both in the PACU and MAC cases.

    In the PACU, I usually give 10-15mg combined with 10mg morphine/piritramide or 10mcg sufentanyl for the postop bariatric patients (gastric bypass or sleeve). They were given prop/remi and 10mg morphine in the OR.

    For sedation we routinely use alfentanyl bolusses and propofol gtt. But this time I put 25mg ketamine in 150mg propofol and run it at 10ml/hr and periodically bolus 1-2ml. Patients weight aprox. 90kg. The patients was very relaxed, didn't respond to pain but responsive if you spoke to them.

    Was I just lucky on these cases or do you think adding ketamine in these relatively low doses made a difference?

    I did a search on 'ketafol' here and most of you use more ketamine, even in a 1-1 ratio. Also, there's no 25mg/ml ketamine in my hospital. Only 25mg/5ml ampules, so mixing a higher concentration would be cumbersome.

    I've also been thinking on mixing:

    - 100mg/10ml propofol
    - 25mg/5ml ketamine
    - 40mg/4ml lidocaine
    - 2,5mg/1ml droperidol or maybe some alfentanyl

    What do you think? Or is this just my bias: 'i've added ketamine so it must work better, right?'
    Last edited by 14gauge; 05-05-2015 at 04:00 PM. Reason: K-hole

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