Davis Wesley D, Davis Kristina A, Hooper Katie
University of South Alabama, Mobile (Dr W. D. Davis); Crook County Medical Services District, Sundance, Wyoming (Dr W. D. Davis); Rocky Mountain University of Health Professions, Provo, Utah (Dr K. A. Davis); and Baylor University Medical Center, Dallas, Texas (Dr Hooper).
Adv Emerg Nurs J. 2019 Apr/Jun;41(2):111-121. doi: 10.1097/TME.0000000000000238.
Ketamine has been used as an anesthetic agent for over 50 years. At the upper end of the dosing range, it displays dissociative anesthetic and amnestic effects, while at lower doses, it acts as an analgesic and demonstrates opioid-sparing capabilities. Ketamine is unique in its preservation of hemodynamic stability and respiratory function, and is used extensively in the emergency department (ED) for procedural sedation and the facilitation of brief painful procedures. Despite evidence supporting its safety and efficacy as an analgesic agent at sub-dissociative doses, its use in the ED for the management of acute pain remains uncommon. New guidelines were published in July 2018 by the American Society of Regional Anesthesia and Pain Medicine, the American Academy of Pain Medicine, and the American Society of Anesthesiologists that provide a framework for identifying patients who are likely to benefit from the use of Ketamine in an acute pain setting.
氯胺酮作为一种麻醉剂已使用了50多年。在给药范围的上限，它表现出解离麻醉和遗忘作用，而在较低剂量时，它起镇痛作用并具有节省阿片类药物的能力。氯胺酮在维持血流动力学稳定性和呼吸功能方面具有独特性，在急诊科广泛用于程序性镇静和辅助进行简短的疼痛操作。尽管有证据支持其在亚解离剂量下作为镇痛药的安全性和有效性，但它在急诊科用于急性疼痛管理的情况仍然不常见。美国区域麻醉与疼痛医学学会、美国疼痛医学学会和美国麻醉医师学会于2018年7月发布了新指南，为识别可能在急性疼痛情况下从使用氯胺酮中获益的患者提供了一个框架。
