AIIMS Nov 2006 Clinical Sciences MCQ 187-188

Answer: 3. Ketamine

• "unique drug"- hypnotic (sleep producing), analgesic (pain relieving) and amnesic (short term memory loss)
  
• no other drug used in clinical practice combines these three important features.
• The anaesthetic state produced is frequently called "dissociative anaesthesia" which implies that the patient is detached from their surroundings
• the patient's eyes often remain open and constantly move from side to side
• the patient may be agitated on recovery from ketamine. This is often called "emergence delirium", during which the patient may be disorientated, restless, and crying
• Ketamine causes a rise in intracranial pressure
• The blood pressure rises by about 25% (on average the systolic pressure rises by 20-30 mmHg) and the heart rate is increased by about 20% - the overall effect is therefore to increase the workload of the heart.
• Ketamine produces some bronchodilation making it a useful anaesthetic drug for patients with asthma
• Muscle tone is often increased
• Ketamine crosses the placenta easily
• not suitable for use in patients with a perforated eye injury or for ophthalmic surgery
• Ketamine may be used as the sole anaesthetic agent for a large number of superficial operations and procedures in both adults and children. Common procedures undertaken with ketamine anaesthesia include minor to intermediate orthopaedic surgery (especially distal arm or lower leg surgery including manipulation of fractures), gynaecological surgery (eg. dilatation and curettage and other minor surgical procedures), drainage of abscesses, debridement of burns, change of dressings and minor dental procedures, as well as a variety of examinations under anaesthesia

Category: AIIMS Nov 2006 MCQs