Experiences of trauma patients given subanaesthetic doses of ketamine

Aim: This study explored the experiences of patients who received an analgesic or sedative (sub-anaesthetic) dose of prehospital ketamine and examined common themes. Background: Ketamine is a powerful dissociative anaesthetic used by prehospital critical care teams. Among its many effects are dissociative episodes, hallucinations and periods of amnesia. It is unclear how these affect patients' processing of trauma. Method: A qualitative phenomenological approach was used, with eight patients interviewed and thematic analysis carried out. Findings: Four major themes arose: amnesia caused by ketamine was beneficial, with patients saying it was useful for mental recovery not to remember unpleasant memories; participants experienced varying degrees of altered reality, which was mainly pleasant although two reported dysphoria related to transition into and out of ketamine's effects; clinicians affected patients' experiences, especially around telling them about ketamine's effects; and patients seemed to perceive motion as it happened. Conclusions: Patients saw ketamine as beneficial. Clinicians should consider their communication, including around preparing patients for receiving this drug. Further research into patients' experience of ketamine should be undertaken as no markedly dysphoric experiences were captured within this study.