4 ms·

Ketamine really was a miracle drug in this situation. It's one of the few anaesthetics that doesn't cause respiratory depression, overdosing is practically imp

Ketamine really was a miracle drug in this situation. It's one of the few anaesthetics that doesn't cause respiratory depression, overdosing is practically impossible, and it's also injected intra-muscularly, rather than intravenously, making it easy to apply in the dark and underwater by an untrained person. These factors are also why it was used extensively in the Vietnam war for battlefield surgery. Interesting that, as usual, the media has labelled it as "horse tranquilliser". It's used more extensively on humans than on animals, and is used on all different mammals, not just horses.

deleted 8y ago
[deleted]
brian-armstrong 8y ago
Definitely true, though waking up from ketamine with your hands bound underwater in pitch black sounds absolutely hellish.
- radiantswirl 8y ago
  Nothing is hellish when you’re waking up from ketamine, dude. If it was, not all of the soccer players would have survived.
darkpuma 8y ago
It's also used on dogs, but mentioning that it works on horses is more impressive since horses are known as very large strong animals. I think that's the reason it's often called a "horse tranquilizer", to emphasize that it's serious stuff. I mean, the article makes clear that Dr. Harry is an anesthesiologist and that anesthesiology is a very serious discipline, so I don't think the author meant to suggest they were carelessly administering medication meant for animals instead of humans.
- sjburt 8y ago
  The irony is that it's actually one of the safest (and cheapest) tranquilizers and that's why it's used on large animals. It's hard to weigh a horse, so you want something that doesn't require a very precise dose.
  - spiralx 8y ago
    They actually use a related chemical, tiletamine, on larger animals due to its increased potency: http://wildpro.twycrosszoo.org/S/00Chem/ChComplex/Tiletamine-Zolazepam.htm http://wildpro.twycrosszoo.org/S/00Chem/ChComplex/Tiletamine...
refurb 8y ago
Ketamine doesn’t get more use due to the unpleasant effects when it wears off. Apparently that’s less common in kids. I would have thought they’d go with a benzodiazepine instead. It has all those benefits you mention without the post-emergence delirium.
- Pharmakon 8y ago
  Benzodiazepines have a depressant effect on the respiratory system, and have a risk of paradoxical reactions. In addition you’d need a heroic dose to cause total sedation, so a benzo is usually only a component of along with an opiate to induce “twilight” sleep. For the purposes of this dive obviously respiratory depression was unacceptable, and doubling down with an opiate would have been worse. Ketamine is very safe, and some nasty side effects are preferable to death.
  - refurb 8y ago
    Benzodiazepines require heroic doses before they start to depress respiration. At low doses, like what you’d use to keep someone calm, it’s a non-issue. Not sure why you’d want them so sedated that they are semiconscious. It doesn’t take much to keep someone from freaking out.
    - toomanybeersies 8y ago
      It would take quite a large doze of benzos to keep someone calm enough to drag them underwater through a cave when they can't swim. You'd also want to stop them from moving about and potentially causing trouble.
    - Pharmakon 8y ago
      The whole point was to fully anesthetize them, not merely sedate them. The risk that they’d panic or become disoriented was too great.
      - refurb 8y ago
        Seems like overkill to me! I’ve seen people given reasonable doses of benzodiazepines be quite compliant!
stef25 8y ago
It's not for nothing that it's not the WHO list of essential drugs. It's a miracle drug in more ways that one, with it now also being used with success against depression in treatment resistant patients, to treat alcoholism etc. And of course nothing beats a good old k-hole experience. The horse tranquilliser thing needs to stop.
sonnyblarney 8y ago
I don't like how this was articulated because giving someone enough drugs to 'knock them out' is extremely dangerous in any circumstance. There are so many things that could have gone wrong during that time, my god man ... random diver dudes (i.e. non medical) giving needles putting people out - this was as dangerous as anything else.

deleted 8y ago

[deleted]

brian-armstrong 8y ago

Definitely true, though waking up from ketamine with your hands bound underwater in pitch black sounds absolutely hellish.

radiantswirl 8y ago
Nothing is hellish when you’re waking up from ketamine, dude. If it was, not all of the soccer players would have survived.

darkpuma 8y ago

It's also used on dogs, but mentioning that it works on horses is more impressive since horses are known as very large strong animals. I think that's the reason it's often called a "horse tranquilizer", to emphasize that it's serious stuff. I mean, the article makes clear that Dr. Harry is an anesthesiologist and that anesthesiology is a very serious discipline, so I don't think the author meant to suggest they were carelessly administering medication meant for animals instead of humans.

sjburt 8y ago
The irony is that it's actually one of the safest (and cheapest) tranquilizers and that's why it's used on large animals. It's hard to weigh a horse, so you want something that doesn't require a very precise dose.
- spiralx 8y ago
  They actually use a related chemical, tiletamine, on larger animals due to its increased potency: http://wildpro.twycrosszoo.org/S/00Chem/ChComplex/Tiletamine-Zolazepam.htm http://wildpro.twycrosszoo.org/S/00Chem/ChComplex/Tiletamine...

refurb 8y ago

Ketamine doesn’t get more use due to the unpleasant effects when it wears off. Apparently that’s less common in kids. I would have thought they’d go with a benzodiazepine instead. It has all those benefits you mention without the post-emergence delirium.

Pharmakon 8y ago
Benzodiazepines have a depressant effect on the respiratory system, and have a risk of paradoxical reactions. In addition you’d need a heroic dose to cause total sedation, so a benzo is usually only a component of along with an opiate to induce “twilight” sleep. For the purposes of this dive obviously respiratory depression was unacceptable, and doubling down with an opiate would have been worse. Ketamine is very safe, and some nasty side effects are preferable to death.
- refurb 8y ago
  Benzodiazepines require heroic doses before they start to depress respiration. At low doses, like what you’d use to keep someone calm, it’s a non-issue. Not sure why you’d want them so sedated that they are semiconscious. It doesn’t take much to keep someone from freaking out.
  - toomanybeersies 8y ago
    It would take quite a large doze of benzos to keep someone calm enough to drag them underwater through a cave when they can't swim. You'd also want to stop them from moving about and potentially causing trouble.
  - Pharmakon 8y ago
    The whole point was to fully anesthetize them, not merely sedate them. The risk that they’d panic or become disoriented was too great.
    - refurb 8y ago
      Seems like overkill to me! I’ve seen people given reasonable doses of benzodiazepines be quite compliant!

stef25 8y ago

It's not for nothing that it's not the WHO list of essential drugs. It's a miracle drug in more ways that one, with it now also being used with success against depression in treatment resistant patients, to treat alcoholism etc. And of course nothing beats a good old k-hole experience. The horse tranquilliser thing needs to stop.

sonnyblarney 8y ago

I don't like how this was articulated because giving someone enough drugs to 'knock them out' is extremely dangerous in any circumstance. There are so many things that could have gone wrong during that time, my god man ... random diver dudes (i.e. non medical) giving needles putting people out - this was as dangerous as anything else.