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by adasound
1102 days ago
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I practice anesthesia. My most significant change so far has been to drastically reduce the amount of ketamine I give. It is a very interesting drug. Very stable re. cardiovascular concerns. Maintains blood pressure nicely. We use it to induce anesthesia and for pain, but others use it for depression, chronic pain, borderline personality disorder. It's fine for pediatrics. Adults not so much. We dose ketamine quite a bit higher as an induction agent at the start of operations than what would be considered a recreational or psychotherapeutic dose/"K hole". In opposition to kids, adult patients have frequently found themselves in a very bad place on emergence from anesthesia and in the recovery room. They sometimes endorse reliving trauma and confronting themselves in a dark region of their minds that they possibly have never known about. This is why it has promise as a therapeutic agent in psychotherapy, however it is often the case that patients are cared for by one recovery room nurse who is run off her feet/has more than one patient. I have learned that "K hole" context is everything. Kids are just fine with ketamine. I think it's because their brains are much more plastic & the variation of experience in their waking lives is higher than adults. I think that experiencing the moods and expressiveness and novel situations as a 3 year old for a day would be an incredible hallucinogen or psychedelic. |
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