Effectiveness and Safety of Ketamine Analgosedation in the Acute Period of Severe Burn Injury

This work is devoted to the topical issue of surgery and anesthesiology, namely, anesthesia and sedation in circulatory shock, in particular, burn shock. The aim of the study was to evaluate the effectiveness and safety of ketamine analgosedation in the acute period of severe burn injury. The pilot study included 9 adult patients aged 15–70 years having a severe burn injury with an area of >40% of the body surface, who were in the intensive care unit for more than 3 days. Intensive care in burn shock was carried out according to the accepted national clinical guidelines. Ketamine after a preliminary bolus (0.25–0.5 mg/kg) was administered through a perfusor (up to 25 mg/h). According to the totality of clinical and laboratory data (dynamics of lactate level, pH, BE, urination rate), shock was controled by the end of the second day from the moment of injury. The assessment of the level of sedation on the RASS scale in patient treated with ketamine showed on average at the level of 2 points during the observation period, the need for narcotic analgesics was limited by the need to perform surgical procedures. Side effects of the use of ketamine (intestinal paresis, vomiting, development of delirium) were not observed. Thus, we can conclude that ketamine analgosedation is safe and effective in burn shock.