CABG and Ketamine #cardiac #pain

Back in residency, I had learned about the wonderful uses of ketamine for pain control…especially in patients with morbid obesity coming in for gastric bypass procedures.  Ketamine worked wonderfully in these patients to decrease the amount of narcotic that could have bad side effects such as respiratory depression.

Then, I got to thinking about CABGs and ketamine for decreasing heavy dose narcotics and aiding “fast-tracking” these cardiac patients.  Lo and behold, I came across these articles that provided me with some information:

So, instead of inducing with ketamine and midazolam, I think I’ll continue my same induction… however, work in ketamine during rewarming from CPB and provide no further narcotic.  I’m wondering if ketamine’s cardiac depressant effects will hurt me during this time.  After that thought, maybe it’s better that I consider ketamine for induction.

Any thoughts?

Author: Kris

Grew up in a small Texas town. Heavily involved in extracurricular activities: piano, violin, dance (ballet/jazz/tap), tennis, horseback riding (english/western), taekwondo, basketball, soccer, volleyball, percussion, drumline, orchestra, band, mascot, pageants. I had the typical Tiger Mom upbringing. Went to college, medical school, residency, and fellowship. Amidst the ups and downs of life, allow me to share with you my an "ordinary" person who happens to be an MD.

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