SHM Converge Scientific Abstract ePoster Gallery-Initial Experience With Low-Dose Ketamine for Analgesia in Hospitalized Patients

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This study evaluated the safety and effectiveness of a low-dose ketamine infusion (LDKA) policy used for hospitalized patients with poorly controlled pain on a general hospital ward. Ketamine, an NMDA receptor antagonist, can provide analgesia with minimal respiratory depression, but higher-dose infusions usually require sedation training and intensive monitoring. The hospital’s off-label LDKA protocol, started in March 2018, allowed infusions beginning at 0.1 mg/kg/hour and increasing by 0.1 mg/kg/hour up to 0.4 mg/kg/hour, without routine monitoring unless clinically indicated.<br /><br />Researchers reviewed electronic medical records of 168 patients who received LDKA between March 2018 and June 2019, excluding ICU, palliative, push-dose, or fixed-rate infusions. Most patients had chronic pain (65%) and psychiatric illness (53%), and 80% of prescriptions were written by surgeons or hospitalists without formal sedation training.<br /><br />Results showed that 62.5% of patients achieved adequate pain relief at infusion rates of 0.3 mg/kg/hour or less. Adverse events occurred in 28% of patients, most commonly nausea (14.3%), followed by hallucinations/vivid dreams, vomiting, confusion/dysphoria, hypotension, and rare double vision. However, only 7 patients discontinued ketamine because of side effects, mainly central nervous system symptoms. Although hypotension occurred in 8 patients, none were symptomatic or required stopping treatment. There were no episodes of respiratory depression or other serious adverse events.<br /><br />Overall, the study concluded that low-dose ketamine infusions can be safely used on general hospital wards as part of multimodal pain management, with low risk of serious complications and no need for routine specialized monitoring in this setting.

Asset Subtitle

Emily H. Garmon

Meta Tag

Author List Emily H. Garmon, Kendra Garmon, Monish A. Sheth, Sharon S. Park

Category Research

Concept Ketamine

Concept Analgesia

Concept Low-Dose Ketamine

Concept Efficacy

Concept Safety

Distinguished Non-Finalist

Presenter Organization Baylor Scott & White Medical Center - Temple

Presenting Author Emily H. Garmon

Track Patient Safety

Keywords

low-dose ketamine infusion

pain management

general hospital ward

safety and effectiveness

adverse events

analgesia

chronic pain

hospitalized patients

multimodal pain therapy

respiratory depression

Ketamine

Analgesia

Low-Dose Ketamine

Efficacy

Safety