Continuous Intravenous Ketamine for Management of Acute Pain Postoperative Laparotomy with Septic Shock: A Case Report

Introduction: Ketamine used for patients in the intensive care unit provides a combination of sedation and analgesia as well beneficial effect on hemodynamics. This study aims to describe use continuous intravenous ketamine postoperative laparotomy pain management septic shock.
 Case presentation: A man, 55 years old, came emergency room with complaints abdominal accompanied by bloating, nausea, vomiting. From anamnesis physical examination support, diagnosis peritonitis generalisata et causa hernia suspect incarceration was found. In observation, vital sign showed blood pressure 80/50, pulse 128x/minute, respiratory rate 24x/minute, temperature 37.7ºC, numeric rating scale 5/10. The treatment patient got simple oxygen mask 6-7 L/ minutes, IVFD ringer lactate 3000 cc/24 hours, ceftriaxone 1gr/12 metronidazole 500 mg/8 norepinephrine 0.15-0.2 mcg/kg/minute titration, dobutamine 7.5 fentanyl 0.5 mcg/kg/hour 0.08-0.1 mg/kg/hour paracetamol drips 1gr/ 6 hours. experienced improvement decreased need from mcg 0.3 mcg/kg/hour.
 Conclusion: addition acute has been shown reduce opioid requirements critically ill patients. low doses together opioids resulted lower cumulative opioids.