What is a potential adverse effect of ketamine that anesthesia providers should anticipate?

What is a potential adverse effect of ketamine that anesthesia providers should anticipate?

• A. Emergence phenomena such as vivid dreams or agitation.
• B. Profound respiratory depression.
• C. Severe hypotension.
• D. Hyperkalemia.

Answer: (A)

Ketamine’s dissociative anesthesia commonly leads to a distinct recovery phase where patients may wake with vivid dreams, hallucinations, or agitation. This emergence phenomenon is a well-recognized adverse effect that anesthesia providers should anticipate and plan for. It reflects the abrupt resumption of integrated neural processing as the NMDA receptor blockade wears off, which can leave patients restless or disoriented as they wake. To reduce this risk, premedication with a benzodiazepine, slower or smoother emergence, and providing a calm recovery environment help. It's also useful to note that, unlike many anesthetics, ketamine generally preserves airway reflexes and spontaneous breathing, so profound respiratory depression is not typical; severe hypotension is less expected and hyperkalemia is not a known effect.

Ketamine’s dissociative anesthesia commonly leads to a distinct recovery phase where patients may wake with vivid dreams, hallucinations, or agitation. This emergence phenomenon is a well-recognized adverse effect that anesthesia providers should anticipate and plan for. It reflects the abrupt resumption of integrated neural processing as the NMDA receptor blockade wears off, which can leave patients restless or disoriented as they wake.

To reduce this risk, premedication with a benzodiazepine, slower or smoother emergence, and providing a calm recovery environment help. It's also useful to note that, unlike many anesthetics, ketamine generally preserves airway reflexes and spontaneous breathing, so profound respiratory depression is not typical; severe hypotension is less expected and hyperkalemia is not a known effect.