Ketamine-Induced Diabetes Insipidus.

Area of Science:

• Anesthesiology
• Nephrology
• Pharmacology

Background:

• Postoperative pain management often requires multimodal analgesia.
• Opioid therapy can be insufficient for severe pain, necessitating alternative agents.
• Ketamine is an N-methyl-D-aspartate receptor antagonist used for analgesia and anesthesia.

Observation:

• A 42-year-old male developed excessive urination and altered urine electrolytes post-surgery.
• These symptoms emerged shortly after initiating a ketamine infusion for pain control.
• The patient was diagnosed with drug-induced diabetes insipidus (DI).

Findings:

• Ketamine administration was identified as the probable cause of DI, supported by a Naranjo scale score of 7.
• Discontinuation of the ketamine infusion led to the resolution of DI.
• Treatment with desmopressin for 5 days was effective in managing the condition.

Implications:

• Clinicians should consider ketamine as a potential cause of unexplained DI in postoperative patients.
• Early recognition and management, including drug withdrawal and desmopressin, are crucial for resolving ketamine-induced DI.
• This case highlights the importance of monitoring fluid and electrolyte balance during ketamine infusions.