My Personal Tryst with Ketamine Anesthesia

I spent a recent Saturday afternoon in the emergency department for an exceptionally painful thrombosed hemorrhoid. Because the operating rooms were unavailable, the surgeon suggested that he could make the small nick necessary to drain the clot in the emergency department procedure room with an emergency department physician serving as the anesthesia provider. As I was not technicallynon per os, having had water and a few raw carrots, the emergency department team decided to use ketamine for my anesthetic. The unpleasant side effects of ketamine are something I am well acquainted with as I have been a practicing physician anesthesiologist for nearly two decades. I therefore requested that midazolam be administered before the ketamine; however, as I was to learn later, my reasonable request was rejected because of an unreasonable fear of aspiration.
Source: Anesthesiology - Category: Anesthesiology Source Type: research