TUESDAY, Feb. 25, 2025 (HealthDay News) — Administration of ketamine for purposes other than acute pain management and procedural sedation should be subject to the same prescribing guidelines as other sedating medications, according to new guidance released by the American Society of Anesthesiologists (ASA).
The ASA notes that ketamine prescriptions are being written by health care professionals who are not trained in safe administration of anesthetic medications and that patients treated with ketamine at outpatient clinics or in their home may not have access to vital sign monitoring, rescue personnel, or emergency resuscitation equipment. For these reasons, the ASA has developed recommendations for the administration of ketamine outside of acute pain management and procedural sedation.
The ASA believes that the general principles for use of ketamine for indications other than anesthesia should follow the same general prescribing principles as other sedating medications. Ketamine should be prescribed as part of a comprehensive treatment plan by an appropriately trained and licensed medical professional who conducts periodic face-to-face visits. A therapeutic end point and defined treatment course should be provided for ketamine treatment. Steps should be taken to ensure use of ketamine therapy as prescribed, and medical professionals should be aware of diversion to nonmedical purposes. The minimum dose necessary to achieve a desired clinical effect should be prescribed. Patients should receive education regarding possible adverse effects of ketamine. Apart from when it is used as a procedural anesthetic, ketamine should not be administered in doses that produce excessive sedation, unconsciousness, or unresponsiveness.
“People who have struggled with mental health issues and are understandably excited about a new treatment may not realize that they are risking their lives by receiving treatment without medical supervision in unaccredited clinics or offices without established safety standards,” Donald E. Arnold, M.D., president of the ASA, said in a statement.
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