Related Experiment Videos
Sedation with ketamine during intradiscal electrothermal therapy
Steven P Cohen1, Thomas Larkin
1Pain Management Centers, Department of Anesthesiology, and Critical Care Medicine, Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA. spc5_2000@yahoo.com
Spine
|July 13, 2004
Summary
Low-dose ketamine effectively sedated patients during intradiscal electrothermal therapy (IDET) when standard medications failed. This novel approach allowed all patients to complete the full heating protocol without adverse effects, improving treatment outcomes.
Area of Science:
- Pain Management
- Anesthesiology
- Spinal Procedures
Background:
- Intradiscal electrothermal therapy (IDET) requires patient sedation.
- Standard sedation with benzodiazepines and opioids is often insufficient, leading to premature procedure termination or reduced efficacy in 5-20% of cases.
- Intolerance to IDET's heating protocol is linked to poorer treatment outcomes.
Purpose of the Study:
- To introduce a new method for sedating patients during IDET.
- To evaluate the efficacy and safety of low-dose ketamine as a rescue medication for patients experiencing axial low back pain during IDET.
- To provide guidelines for the judicious use of ketamine in this context.
Main Methods:
- A technical report detailing the use of ketamine in 9 patients undergoing IDET.
- Patients received low-dose ketamine as a rescue medication for refractory axial low back pain during the heating phase.
- Concurrent administration of midazolam was used to mitigate ketamine's psychomimetic effects.
Main Results:
- All 9 patients successfully completed the full IDET heating protocol after receiving ketamine.
- Ketamine dosages ranged from 15 to 55 mg, with midazolam dosages from 3 to 7 mg.
- No significant changes in oxygen saturation or hemodynamics were observed, and all patients remained responsive without adverse events.
Conclusions:
- Low-dose ketamine serves as a safe and effective rescue medication for managing axial back pain during IDET.
- Judicious use of ketamine enables patients to tolerate the complete IDET heating protocol.
- This approach enhances the potential success of IDET treatment.