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Canadian Journal of Anesthesia, Vol 40, 160-164, Copyright © 1993 by Canadian Anesthesiologists' Society

ARTICLES

Hypertension and pulmonary oedema associated with ketamine administration in a patient with a history of substance abuse

JL Murphy Jr
Ohio State University, College of Medicine, Department of Anesthesiology, Columbus 43210.

Cocaine use, frequently associated with other substance abuse, is becoming more common in the pregnant patient. These patients are more likely to experience peripartum complications. A case of hypertension and pulmonary oedema in such a patient, possibly triggered by ketamine, is reported. A tumultuous course in the intensive care unit was resolved when the patient's hypertension and sympathetic reactivity were successfully treated with barbiturates. A number of factors supported a diagnosis of barbiturate withdrawal in this patient, its onset also was related temporally to ketamine administration. Hypertension should be considered a sign of acute barbiturate withdrawal. If a history of cocaine use, particularly crack cocaine, is elicited, one should suspect multiple substance abuse and be especially cautious when administering ketamine.


This article has been cited by other articles:


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 Canadian J. AnesthesiaHome page
K. M. Kuczkowski
The cocaine abusing parturient: a review of anesthetic considerations: [L'abus de cocaine chez les parturientes : une revue des aspects anesthesiques]
Can J Anesth, February 1, 2004; 51(2): 145 - 154.
[Abstract] [Full Text] [PDF]

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 Canadian J. AnesthesiaHome page
C. K. Pandey, N. Mathur, N. Singh, and H.C. Chandola
Fulminant pulmonary edema after intramuscular ketamine
Can J Anesth, September 1, 2000; 47(9): 894 - 896.
[Abstract] [Full Text] [PDF]


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Copyright © 1993 by the Canadian Anesthesiologists' Society.