Practice Consideration

Ketamine Infusion (Practice Consideration)

Last AANA revision: 2024

Our paraphrased summary. The text below is our own condensed phrasing for board review, derived from the AANA Practice Manual document of the same name. The AANA document is the authoritative source — read it on aana.com for legally-binding language.

Sub-anesthetic ketamine infusions (0.1–0.5 mg/kg/hr) reduce postoperative opioid requirements, improve pain in opioid-tolerant patients, and may prevent chronic post-surgical pain. Particularly useful for: spine surgery, thoracotomy, opioid-tolerant patients, complex regional pain syndrome.

Key points

1.Intraop bolus 0.25–0.5 mg/kg pre-incision + infusion 0.1–0.3 mg/kg/hr
2.Postop infusion 0.1–0.2 mg/kg/hr (PACU + ward, monitored bed)
3.Side effects: dissociation, vivid dreams, hypertension, salivation. Co-administer benzodiazepine for psychomimetic at higher doses.
4.Monitoring: ramsay sedation score, vital signs q4h, no separate cardiac monitoring needed at sub-anesthetic doses
5.Contraindications: severe CAD (relative — at sub-anesthetic doses minimal cardiac stress), uncontrolled HTN, psychosis history

This is an exam-prep summary, not a substitute for the full AANA document. Read the source at aana.com for authoritative wording. Education only.