Objective
To analyse efficacy, safety and complications of dissociative anesthesia with ketamine plus benzodiazepine in a prehospital setting.
Materials and methods
A retrospective series of 33 cases from January 1998 to December 1999, in which dissociative anesthesia with ketamine plus midazolan was used to provide anesthesia to prehospital trauma patients, most of them trapped in vehicles. A protocol was developed in 1997, and its use was the decision of the attending physician in patients with a revised trauma score 11 or 12. The data were collected from the patient form.
Results
Ketamine was administrated by intravenous route in 96.9% of cases. In 66.6% of the cases, patients received ketamine parallel to the extrication procedure. All patients became unconscious. The most frequent complications were agitation (9.09%), clonic eye movements (3.03%) and transient ventilatory depression (3.03%). None of the patients necessitated a definitive airway.
Conclusion
Dissociative anesthesia with ketamine plus benzodiazepine is efficacious and safe in a prehospital setting, in patients with a revised trauma score of 11 or 12.