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Possible gabapentin and ketamine interaction causing prolonged central nervous system depression during post-operative recovery following cervical laminoplasty: a case report.

Elyassi AR, Long RP, Bejnarowicz RP, Schoneboom BA - J Med Case Rep (2011)

Bottom Line: All organic causes were excluded, with the exception of prolonged central nervous system depression from a gabapentin/ketamine drug interaction.A new onset conversion disorder could also not be excluded.Although this case by itself is not enough evidence to substantiate a true adverse reaction between gabapentin and ketamine, it is enough to warrant further investigation.

View Article: PubMed Central - HTML - PubMed

Affiliation: Tripler Army Medical Center, Department of Surgery, 1 Jarrett White Road, Honolulu, HI 96859-5000, USA. aelyassi@gmail.com.

ABSTRACT

Introduction: The drugs gabapentin and ketamine are used frequently in the peri-operative setting. There is poor documentation whether or not gabapentin and ketamine interact to cause prolonged depression of the central nervous system.

Case presentation: The following is a case report in which a patient, a 58-year-old African-American man, with a history of post-traumatic stress disorder and chronic pain underwent a cervical laminoplasty procedure. The patient presented post-operatively in a dissociative state with paralysis, anarthria and preservation of consciousness. All organic causes were excluded, with the exception of prolonged central nervous system depression from a gabapentin/ketamine drug interaction. A new onset conversion disorder could also not be excluded.

Conclusion: Although this case by itself is not enough evidence to substantiate a true adverse reaction between gabapentin and ketamine, it is enough to warrant further investigation.

No MeSH data available.


Related in: MedlinePlus

Sagittal T2-weighted MRI showing narrowing of spinal canal at C3-C7.
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Figure 1: Sagittal T2-weighted MRI showing narrowing of spinal canal at C3-C7.

Mentions: A 58-year-old African-American man presented to our neurosurgery clinic for cervical spinal stenosis. He had an approximate one-year history of slowly declining ability to ambulate, chronic pain in both hands, as well as mild paresthesias and decreased sensation involving fingers on both hands. Additionally, he described grip weakness, greater in his left than right. Both computed tomography (CT) and magnetic resonance imaging (MRI) revealed multi-level degenerative disc disease, causing narrowing of his spinal canal at cervical levels 3-7 (C3-C7) (Figure 1). Given our patient's clinical presentation and radiographic evidence of cervical spinal stenosis, he was scheduled for a C3-C7 laminoplasty for spondylosis and myelopathy.


Possible gabapentin and ketamine interaction causing prolonged central nervous system depression during post-operative recovery following cervical laminoplasty: a case report.

Elyassi AR, Long RP, Bejnarowicz RP, Schoneboom BA - J Med Case Rep (2011)

Sagittal T2-weighted MRI showing narrowing of spinal canal at C3-C7.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3104365&req=5

Figure 1: Sagittal T2-weighted MRI showing narrowing of spinal canal at C3-C7.
Mentions: A 58-year-old African-American man presented to our neurosurgery clinic for cervical spinal stenosis. He had an approximate one-year history of slowly declining ability to ambulate, chronic pain in both hands, as well as mild paresthesias and decreased sensation involving fingers on both hands. Additionally, he described grip weakness, greater in his left than right. Both computed tomography (CT) and magnetic resonance imaging (MRI) revealed multi-level degenerative disc disease, causing narrowing of his spinal canal at cervical levels 3-7 (C3-C7) (Figure 1). Given our patient's clinical presentation and radiographic evidence of cervical spinal stenosis, he was scheduled for a C3-C7 laminoplasty for spondylosis and myelopathy.

Bottom Line: All organic causes were excluded, with the exception of prolonged central nervous system depression from a gabapentin/ketamine drug interaction.A new onset conversion disorder could also not be excluded.Although this case by itself is not enough evidence to substantiate a true adverse reaction between gabapentin and ketamine, it is enough to warrant further investigation.

View Article: PubMed Central - HTML - PubMed

Affiliation: Tripler Army Medical Center, Department of Surgery, 1 Jarrett White Road, Honolulu, HI 96859-5000, USA. aelyassi@gmail.com.

ABSTRACT

Introduction: The drugs gabapentin and ketamine are used frequently in the peri-operative setting. There is poor documentation whether or not gabapentin and ketamine interact to cause prolonged depression of the central nervous system.

Case presentation: The following is a case report in which a patient, a 58-year-old African-American man, with a history of post-traumatic stress disorder and chronic pain underwent a cervical laminoplasty procedure. The patient presented post-operatively in a dissociative state with paralysis, anarthria and preservation of consciousness. All organic causes were excluded, with the exception of prolonged central nervous system depression from a gabapentin/ketamine drug interaction. A new onset conversion disorder could also not be excluded.

Conclusion: Although this case by itself is not enough evidence to substantiate a true adverse reaction between gabapentin and ketamine, it is enough to warrant further investigation.

No MeSH data available.


Related in: MedlinePlus