Morphine is the standard of care in the treatment of pain, but if a patient has allergies or high opioid needs, ketamine is a great adjuvant analgesic.

Not really. The hallucinations associated with ketamine could be confused with mental status changes in this fragile population.

There are no specific populations that should avoid ketamine. Rather, the decision to avoid ketamine use is more individual and patient specific—such as in patients with increased intracranial pressure, cardiovascular disease, end-stage liver disease, or a history of psychosis.

Ketamine is contraindicated for patients with increased intracranial pressure. In addition, if the patient has a traumatic brain injury, administration of ketamine can make assessments challenging.

Yes, it is very effective and appropriate for patients with chronic pain who have been receiving opioid therapy for a while. Consider ketamine for short-term use, as it can “reset” opioid receptor sites....

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