Dissociative Anesthesia is defined as an altered state of consciousness induced through drugs or alcohol, or other substances (neuroleptics). Duly called a trance, it can be extremely beneficial in helping patients overcome certain challenges such as phobias, compulsive disorders, or post-traumatic stress disorders. However, in this article I will cover the history and uses of Dissociative Anesthesia, and how and why it is used to treat certain mental conditions. Please keep in mind that the information here is not intended to medically diagnose or treat any condition, but to offer a general knowledge on the subject (1).
Anesthesia can be divided into two categories, namely central and peripheral. Central Anesthesia simply impairs consciousness; the patient cannot feel anything at any given time. This is caused by a blockage in the nerves. Peripheral Anesthesia involves the presence of an unconscious mind or sub-conscious. While these two types of anesthesia have different effects, they are both used for the same treatment.
Ketamine as a Dissociative Anesthetic
Ketamine, also known as Norkit, is a dissociative anesthetic agent. It is commonly administered in clinical trials for treating patients with depression and anxiety. The primary feature of ketamine is its ability to reduce the effects of anxiety and depression while increasing the amelioration of moods. A secondary, yet crucial, role of ketamine is to relieve the physical and psychological effects of seizures and schizophrenia (2).
Other Commonly Administered Dissociative Anesthetic Agents
Commonly administered dissociative anesthetic agents are PCP (preparations of sodium chloride) and DXM (commonly known as cough syrup). PCP is a white crystalline powder that is dissolved in a glass of water. It is administered by a trained nurse or paramedic, usually with the assistance of another person during the administration process. DXM is a warm salt solution that is dissolved in the same solution (3).
Both agents cause an increase in heart rate and blood pressure. Although the effects of ketamine can reduce the cardiovascular effects of stress, it has been shown to increase blood pressure when it is administered alone. When combined with other medications, however, ketamine can lead to the development of a new medical condition known as orthostatic hypotension.
The common street name for dissociative anesthetic drugs is ‘ketamine’. These drugs were first manufactured as a legal pharmaceutical drug under the trade name of ‘MPH’ (mono-phenylenediamine). It was not until sometime in 1996 when this drug was put on the list of Schedule II drugs that the medical community recognized the true dangers associated with its use. Because of this, the FDA began to ban the use of the term ‘ketamine’ and redesignate it as ‘Ketamine’ or ‘Dissociative Anesthesia’ to replace the illegal street names.
There are several different ways that dissociative anesthetic drugs can affect an individual. Generally, it is thought that ketamine produces a type of amnesia where the patient does not remember anything that happens to them while under anesthesia. This amnesia, however, can vary significantly from patient to patient. Some patients report never having any memory of the time that they spent in the hospital receiving anesthesia.
Ketamine can also affect the level of consciousness. A minority of patients report only a mild effect where they do not feel anything at all. More commonly, however, patients become aware of their surroundings during the procedure but are unaware of anything that is going on around them. This effect is most commonly seen in children who have a low level of consciousness at birth. This means that the effects of the drug are not as drastic as they would be if the patient were to take a dose of General anesthesia. Also, ketamine is commonly used for minor procedures in the dental field.