Could DXM hypothetically be used as a surgical anesthetic?

[Daddy hot tub]

Say you don't have access to something more conventional like ketamine, could a 3rd or 4th platue dose provide a reasonable amount of analgesia for surgery? Just curious, and move this to a different discussion if it doesn't belong.

 

[CrypticArc]

I would not call ketamine "conventional" for surgical use. lol

anyway I would think the nausea from the DXM would render it useless as an anesthetic.

 

[Renald]

Say you don't have access to something more conventional like ketamine, could a 3rd or 4th platue dose provide a reasonable amount of analgesia for surgery? Just curious, and move this to a different discussion if it doesn't belong.

Interesting question. Are high plateaus safe from medical point of view? We cant think about dxm as a typical dissociative, it is SNRI in the first place.

 

[Clocktower]

Actually, ketamine is in common medical use as an anesthetic, when conditions preclude the use of other anesthetics that suppress breathing more than ketamine does.

As for the OP, absolutely fucking not. In what hypothetical scenario does a surgeon have access to DXM but not ketamine?

 

[Daddy hot tub]

Probably no senario lol, maybe there was a plane crash, and someone had a piece of shrapnel logdeged in their abdomen and a surgeon was on the plane but the only thing they had access to was a couple bottles of robitussion, kinda like the first episode of lost

 

[boselect]

Actually, ketamine is in common medical use as an anesthetic, when conditions preclude the use of other anesthetics that suppress breathing more than ketamine does.

As for the OP, absolutely fucking not. In what hypothetical scenario does a surgeon have access to DXM but not ketamine?

Was given ketamine for surgery on my femur. Was given fentanyl when arriving in hospital by a doctor (i had been drinking heavily for maybe 10 hours before breaking my femur but was unable to communicate that to anybody beforehand) and the surgeon got pretty annoyed that he couldnt use whatever he was planning to use in the first place because of the fent + alcohol levels in me.

DXM seems ridiculous though, even if for some reason it was to hand.

 

[Fresnel]

I would not call ketamine "conventional" for surgical use. lol

It's on the WHO's list of essential meds. It's widely used in places where breathing equipment is unavailable. It's also used in pediatric and geriatric cases.

herpity derp, etc

 

[CrypticArc]

it's still relatively uncommon compared to more widely used anesthetics.

 

[Solipsis]

OK so miscommunication: conventional use as anaesthetic in general is not the same as the conventional anaesthetic for specific (though not uncommon) situations.

@OP question, my opinion:

Even ketamine, which appears to be one of the dissociatives with the highest anaesthetic component compared to its stimulation, is still usually administered with a heavy benzo like midazolam. I'm not sure that it's really purely to make the patient forgetful of trippy experiences, or also to counter stimulating effects and ensure anaesthesia.
DXM is more stimulating on account of the SNRI which is problematic since it prevents "full" anaesthesia.
In that hypothetical scenario of yours it depends on whether there are benzos to counter the stimulation and whether the injury is serious enough to risk death by aspiration or from an OD of DXM and if operation is possible potentially without the patient being unconscious / immobile.