Sedation with Ketamine to Catch Up with a Failed Sedation using Midazolam
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2019, Vol 16, Issue 1
Abstract
Background: The problem of treatment-refractory symptoms is common in palli-ative care practice. In such circumstances, it is possible to sedate with midazolam. We propose here the case of a patient who benefited from deep sedation with ketamine as a rescue of a failed sedation with midazolam for refractory dyspnea.Case presentation: Mrs. X, 76 years, with a weight of 50 Kg, was known since 2008 for breast cancer with lungs and liver metastasis. Only palliative care was delivered since one year. She was hospitalized in the geriatric department for pulmonary sepsis with bilateral pleural effusion. Because of a refractory dyspnea, it was decided, after discus-sion with the patient and his family, to start deep sedation using midazolam. Despite important midazolam doses, the comfort state of the patient was considered insufficient. With the support of the Mobile Palliative Care Team, deep sedation with ketamine was successfully carried out as a catch-up. Discussion: It appears from experience that ketamine seems to be a good drug al-ternative in the event of the failure of deep sedation with midazolam, and especially a much simpler and more secure alternative to put in place in a routine care service than propofol sedation.Conclusion: Ketamine appears to be a good alternative in case of midazolam sedation failure. This option is secure, manageable and easily accessible, unlike propofol. It is worth considering the conduct of clinical trials, given the interest of the palliative medi-cal community in this therapeutic alternative in situations of midazolam sedation failure.
Authors and Affiliations
Raphaël Alluin, Johann Laangry, Elodie Andrée
Keywords
Related Articles
- EP ID EP590790
- DOI 10.26717/BJSTR.2019.16.002791
- Views 187
- Downloads 0
Aristotle: On Intuition and Induction in Research on the Universe
In the ancient Greek culture and philosophy statements about the world had cosmologic and cosmogonic character. The first were totally (like, for example, in Thales’, Anaximander’s, Heraclitus’ philosophy) or partially c...
A Comparative Cross Sectional Study on the Awareness and Attitude towards Rubella Vaccine among the Medical and Non-Medical Students of Trichy District, Tamil Nadu
Introduction: Rubella virus when contracted by pregnant women, causes serious complications including rubella syndrome (CRS). Sensorineural hearing loss is one of the most common complication associated with CRS. In deve...
In vitro Assessment of Anti-aging Properties of Syzygium cumini (l.) Leaves Extract
Syzygium cumini (L.) Skeels (Myrtaceae) is known to contain phenolic compounds and antioxidant activity of its fruit, bark, and seeds have been investigated. However, there is limited information available regarding biol...
Synthesis and screening of some novel 1-((5-phenyl-1,3,4- oxadiazol-2-yl)methyl)-3-((piperazin-1-yl)methyl)-1Hindazole
A series of some novel 2-[5-(substituted phenyl)-[1,3,4]oxadiazol containing 1H-indazole moiety were synthesized by using of indazole with mannich base on reaction to give 3-(piperazin-1-yl)methyl)- 1H-indazole which is...
Continuous Intra-Abdominal Pressure Measurement: Re-Discovered
Last year was the 10th anniversary of the first publication on Polycompartment Syndrome. The term "Multiple Compartment Syndrome" was introduced by Scalea in 2007 suggesting the complex interplay between body compartment...