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Author: Admin | 2025-04-28
Local regulations and individual institutional policies and procedures. Monitoring ParametersHeart rate, blood pressure, respiratory rate, transcutaneous O2 saturation, emergence reactions; cardiac function should be continuously monitored in patients with increased blood pressure or cardiac decompensation PregnancyPregnancy ConsiderationsKetamine crosses the placenta (Ellingson 1977; Little 1972).Ketamine produces dose dependent increases in uterine contractions; effects may vary by trimester. The plasma clearance of ketamine is reduced during pregnancy. Dose related neonatal depression and decreased Apgar scores have been reported with large doses administered at delivery (Little 1972; Neuman 2013; White 1982).Based on animal data, repeated or prolonged use of general anesthetic and sedation medications that block N-methyl-D-aspartate (NMDA) receptors and/or potentiate gamma-aminobutyric acid (GABA) activity may affect brain development. Evaluate benefits and potential risks of fetal exposure to ketamine when duration of surgery is expected to be >3 hours (Olutoye 2018).Although obstetric use is not recommended by the manufacturer, ketamine has been evaluated for use during cesarean and vaginal delivery (ACOG 209 2019; Akamatsu 1974; Galbert 1973). Ketamine may be considered as an alternative induction agent in females requiring general anesthesia for cesarean delivery who are hemodynamically unstable (Devroe 2015). Use of ketamine as an adjunctive analgesic in cesarean section has also been evaluated; however, use for this purpose may require additional studies (Carvalho 2017; Heesen 2015). When sedation and analgesia is needed for other procedures during pregnancy, low doses of ketamine may be used, but other agents are preferred (Neuman 2013; Schwenk 2018). Use of ketamine infusion for the treatment of refractory status epilepticus in a pregnant patient has been noted in a case report (Talahma 2018).The ACOG recommends that pregnant women should not be denied medically necessary surgery, regardless of trimester. If the procedure is elective, it should be delayed until after delivery (ACOG 775 2019). Patient EducationWhat is this drug used for?It is used to cause sleep during a procedure. It is used to put you to sleep for surgery. It may be given to you for other reasons. Talk with the doctor.Frequently reported side effects of this drugFatigue Lack of appetite Vomiting NauseaOther side effects of this drug: Talk with your doctor right away if you have any of these signs of:Severe dizziness Passing out Difficulty breathing Slow breathing Shallow breathing Slow heartbeat Abnormal heartbeat Severe headache Confusion Sensing things that seem real but are not Behavioral changes Stiff muscles Seizures Vision changes Involuntary eye movements Signs of a
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