Motion During the Procedure

Motion During the Procedure
Unlike other sedatives, ketamine does not produce muscle
relaxation. Random purposeless movements unrelated to painful
stimuli (including hypertonicity and clonus) may occur, and at
times adjunctive physical immobilization may be needed.4,19,71
Adjunctive local anesthesia is typically unnecessary for
wounds and other procedures when ketamine is administered in
dissociative doses.4,19,71
Supplemental Oxygen
The literature strongly supports the safety of ketamine in
patients breathing room air.4,19,72 Oxygen supplementation
may delay the detection of respiratory depression by pulse
oximetry11,86-88 and it appears best reserved for when
capnography is being used to monitor ventilation.
Interactive Monitoring
The practitioner dedicated to monitoring must be prepared
to occasionally reposition the head for optimal airway patency
or suction the pharynx.4,19,71 Any sterile drapes should ideally
be positioned to permit continuous visualization of the airway
and chest motion.