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Analgesia or anesthesia, Ketaimine can perform both roles. For deep skeletal muscle analgesia it works great, but for abdominal injury/surgery not so great. In crash C-Section’s we use it when unable to obtain a spinal/epidural. (generally have tried for the spinal and the pt. is now on the table and you are looking at a horrible airway.) I have used high dose ketamine with the surgeon injecting local as they cut through each layer. This was one of the more extreme use’s. And it certainly sucked for that patient.
The nice thing about ketamine is the fact that it is not a respiratory depressant. If used in an induction of general anesthesia it can buy you some time and not put the patient into too much of harms way. Precedex has been used more and more lately in that role, and I have found it useful during difficult airways.
Now to fentanyl; this drug is highly potent, unless the patient is on a monitor it should never be administered IV. Also I have heard of overdoses with the transdermal patch when the patient used a hot pad over the site, And in Florida a couple of years ago a Dentist prescribed it too a 16 year old. He put it on and went too sleep on a heated water bed. He subsequently overdosed and died.
And then there is the drug addicts who cut them open and eat the gel. This has helped more than a few addicts too finally get that :”big sleep” that they seem to be looking for
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