Ketamine in Trauma: A Literature Review and Administration Guidelines

Kristen Reede; Reid Bartholomew; Dana Nielsen; Mentor Ahmeti; Khaled Zreik

doi:10.7759/cureus.48099

Ketamine in Trauma: A Literature Review and Administration Guidelines

Cureus. 2023 Nov 1;15(11):e48099. doi: 10.7759/cureus.48099. eCollection 2023 Nov.

Authors

Kristen Reede¹, Reid Bartholomew², Dana Nielsen¹, Mentor Ahmeti³, Khaled Zreik⁴

Affiliations

¹ General Surgery, University of North Dakota School of Medicine and Health Sciences, Grand Forks, USA.
² Trauma Surgery, University of Tennessee Health Science Center, Memphis, USA.
³ Surgery, Sanford Medical Center, Fargo, USA.
⁴ Surgical Critical Care, Sanford Medical Center, Fargo, USA.

Abstract

Ketamine is a phencyclidine (PCP) derivative, which primarily acts as a noncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist. Ketamine serves as an analgesic and a dissociative sedative that produces potent analgesia, sedation, and amnesia while preserving spontaneous respiratory drive. It is rapidly gaining acceptance in the management of pain as multiple studies have demonstrated its reliable efficacy and a wide margin of safety. This article reviews some of these studies, the history of ketamine, and its pharmacological and pharmacokinetic properties. The article also discusses the use of ketamine in the trauma setting, including joint reductions, procedures, sedation, and pain control, as well as dosing recommendations.

Keywords: dissociation; ketamine; ketamine administration; ketamine dosing; ketamine utility in trauma; pain control; procedural sedation and analgesia; trauma.

Publication types

Review