I have amended my statement about ketamine being "very safe" to "considered safe" to help allay perception that I may think it is something to be taken lightly. Any IV drug therapy should be considered seriously, including bisphosphonates.

This is a good time for discussion about the use and safety of ketamine. Purplefoot need not fear ketamine being a "horse tranquilizer". The drug does have a stigma as a vet medicine. However it is used worldwide in diverse populations from toddlers to the elderly, from trauma to burn victims. Ketamine was originally used in field surgical settings by the military because it does not depress the airway like other anesthetics. It is currently used in developing countries in operative settings as its safety and ease of use allow it to be utilized in places that don't have a lot of high dollar equipment. It is considered safe to use in pediatric populations as young as 18 months for sedation in the Emergency Department, where no anesthesiologist is present. Its use is becoming much more broad and benefits are being found in new applications including treatment of depression when given at low doses.

Ketamine therapy for CRPS in the USA is not given in the "coma" doses first tried in Germany that some are familiar with. It is not even given in doses as high as those used for short term anesthesia. Treatment here is sub-anesthetic and typically done at a level that is given as an outpatient. My own dose is so low that when one of my doctors asked about my therapy she started chuckling. When I looked at her sideways, she said "I am laughing at your tiny little ketamine dose". It is about a 6th of what would be given for other purposes.

Don't worry, monitoring is constant and there should be a blood pressure cuff and pulse-ox on Purplefoot all the time. Ketamine exits the system quickly so in the event there is any problem at all, they can adjust the dose to pretty immediate effect.