Anaes SAQs · Anaesthetic adjuncts

Subanaesthetic ketamine as an analgesic adjunct

Second-part SAQ on subanaesthetic ketamine as an analgesic adjunct — the NMDA anti-hyperalgesic mechanism (not simple analgesia); the opioid-sparing effect across 70 randomised studies (Laskowski) with PONV reduction (Sung); the prevention of opioid-induced hyperalgesia and tolerance (Niesters) with the dexamethasone complementary pathway (Hong) and palliative prescribing context (Chen); the neuropathic-pain efficacy including the topical route (Rav); the esketamine advantage and the rapid antidepressant effect (Niesters, Al Subhi); the taught dosing bands 0.1 to 0.5 mg per kg bolus and per kg per hour infusion; the adverse-effect profile at adjunct doses (psychotomimetic, sympathomimetic, hypersalivation, nystagmus) and the notable absences (no respiratory depression, no histamine release).