Ketamine
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Somnolence, disorientation and atelectasis: case report A 38-year-old man developed somnolence, disorientation and atelectasis during treatment with ketamine for pain. The man, who was shot in an attack, was evacuated to United States Special Operation Command. He was tachycardic and febrile at arrival. Additionally, left femur fracture, trans-pelvic gunshot wound, blood in rectal vault and abdominal tenderness were also noted. He was taken to the operating room and cystostomy was performed due to suspected prostatic urethral injury. For analgesia, ketamine infusion was started at a rate of 2.5 µg/kg/min, which was later titrated down to 1.7 µg/kg/min. Concomitantly, ketorolac and paracetamol were also administered. While receiving ketamine infusion, he developed somnolence. He was arousable, but could not remain awake unless engaged in some activity, altered mental status was observed, suggestive of disorientation. On post operative day 2, he was diagnosed with atelectasis, which was confirmed by a chest CT scan. On day 2, he also developed oxygen desaturation [times to reactions onsets not stated]. The man was treated successfully with initiating oxygenation via nasal canula and was evacuated to a high level of care. On day 3, a CT scan showed bibasilar atelectasis, fracture of the left acetabulum and left femoral head along with pelvic hematoma [not all outcomes stated]. Hall AB, et al. Ketamine Use for Prolonged Field Care Reduces Supply Use. Journal of Special Operations Medicine 20: 120-121, No. 3, 2020. Available from: URL: https:// 803518808 pubmed.ncbi.nlm.nih.gov/32969016/
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Reactions 5 Dec 2020 No. 1833
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