Definition Dissociative anesthesia is a unique method of pain control. It reduces anxiety and produces a trancelike state. The person is not asleep, but rather feels separated from his or her body.
Who is a candidate for the procedure? Dissociative anesthesia is useful in emergency situations, such as an injury. It can also be used for short procedures that are painful, such as changing bandages. This method is safe and lasts only a short time. Because a person does not usually recall the procedure, this method is useful in children.
How is the procedure performed? The medications used for dissociative anesthesia are given through a shot into a muscle or through an intravenous line,or IV. An IV is a thin tube that is usually placed into one of the veins of the forearm or hand. The medication quickly takes effect. The primary medication used is called ketamine. A sedative is often given before ketamine to reduce anxiety.
A single dose of ketamine produces a trancelike state for about 10 to 30 minutes and pain control for about 30 to 45 minutes. A pinprick is often used to make sure the person doesn't feel pain. The procedure is then performed. Additional doses of medication can be given if the procedure takes longer than expected. The individual's eyes stay open during the procedure, but he or she is in a daze and feels no pain.
What happens right after the procedure? A person who has had dissociative anesthesia usually does not remember the procedure, especially if a sedative has been given along with the pain medication. Most people feel back to normal within a few hours. As the medication wears off, an individual may have intense dreams and even hallucinations. If the procedure corrects the problem and a hospital stay is not needed, the person can go home. Someone else must drive the person home, because the medications can impair coordination and reflexes for several hours.
What happens later at home? Once at home, a person may have effects as a result of the procedure or injury, but usually not as a result of the medication used for dissociative anesthesia.
What are the potential complications after the procedure? When the medication is wearing off, a person may have frightening dreams or hallucinations. Dissociative anesthesia is generally avoided in a person with a psychosis because it can cause severe anxiety. Other problems are rare, although allergic reactions to the anesthesia are possible.
The American Society of Anesthesiologists recently issued a warning about the potential side effects and interactions of herbal remedies with medications used before, during, and after surgery. The group recommends discontinuing all herbal remedies and supplements at least two weeks before planned surgery.
Author: Adam Brochert, MD Reviewer: Eileen McLaughlin, RN, BSN Last Updated: 11/06/00 Contributors Potential conflict of interest information for reviewers available on request
