Dr. Lyness...I've had occasion to use ketamine perhaps 10 times in the field. Nine of those were with excellent results. One pt had a "horrible" emergence reaction, but by the time we left him at hospital he was very glad to have had our services (motorcycle accident).
Here is my only concern. Dosages seem to be all over the place. Your nasal dose for analgesia, for example, makes sense when you look at your suggested IV dose for analgesia, but both are quite a bit lower than what I've heard otherwise to date. Specifically, around 1mg/kg for analgesia, and around your analgesia doses WHEN COMBINED with, say, low dose morphine. I have looked extensively throughout the online literature for some consensus dosages for ketamine for analgesia, simple sedation, excited delirium, etc but I find no such consensus. Any thoughts?
Hi Grant - thanks for this. Are you on Twitter? This gets discussed.. A LOT. Come on twitter and send me a message! We have Minh LeCong and Sergey Motov, both venerable prescribers of ketamine in the field who I will introduce to you - it's much easier to discuss there! Excellent discussion point (www.twitter.com/gas_craic) I'll post a topic now on Twitter to see what people think :-)
Dr. David Lyness