Ketamine is a potent analgesic medication but causing less sedation preserves the balance between sedation and wakefulness. Ketamine also has unique neuro-friendly pharmacological profile and neuroprotective, anti-seizure properties but its role in NSICU unit is not well defined. We describe our experience about the use of ketamine in neuro-critical care unit

Twenty patients with varied brain injury on ketamine infusion as first line agent were analyzed. Mean age was 62.9 years (range 22-88 years) and 12 patients were male. Admitting diagnosis was hemorrhagic stroke (40%), ischemic stroke (40%), seizures (10%), carotid stenosis (5%) and tumor mass (5%). Mean duration of ketamine infusion was 3.15 days (range 1-8 days) and dose range was 2-15 mcg/kg/min, among the 5 patients where the ICP was monitored no ICP elevation was noted. No uncontrollable elevated blood pressures, major fluctuation in heart rate or respiratory rate required discontinuation of ketamine. 13 (65%) patients had increased secretions without respiratory compromise. Opioid use decreased significantly moreover additional sedation was not required while on ketamine infusion