• Francis Remerand, Claude Couvret, Xavier Pourrat, Charlotte Le Tendre, Annick Baud, and Jacques Fusciardi.
• Groupement d'Anesthésie Réanimation, Hôpital Trousseau, CHU de Tours, Tours, France. fremerand@chu-tours.fr
• Therapie. 2007 Nov 1;62(6):499-505.

ObjectiveContinuous low dose infusion of intravenous ketamine for postoperative analgesia was often associated with frightening acute psychodysleptic experiences in our patients. We hypothesized they were due to boluses of ketamine accumulated in the infusion line. We evaluated on two successive groups the impact of perfusion line modifications on psychodysleptic side effects occurrence.MethodsWe compared a reference historic group (in which ketamine line was connected to perfusion line) to a second prospective group (in which ketamine line was connected to the venous catheter via an unidirectional valve).ResultsPsychodysleptic experiences occurrence decreased from 4 patients of 26 (15%) to 2 of 116 (2%, p = 0.01). Moreover, these experiences were no longer associated with severe anxious symptoms like near death experiences.ConclusionAn unidirectional valve must be considered to limit the occurrence of low dose intravenous ketamine infusion associated psychedelic side effects, during postoperative analgesia.

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