2025-12-08 – Weekly CRNA News : Ketamine and SSRIs affect BIS monitoring

Last week’s forum was buzzing with insightful discussions around medication interactions, quality assurance challenges for new CRNAs, and efficient use of technology in regional anesthesia. Members shared experiences and advice on managing these complex aspects of CRNA practice, providing valuable perspectives for both seasoned professionals and those new to the field.


This Week’s Hot Topics

Ketamine on SSRIs makes BIS chatty
A lively thread where members are dissecting how ketamine, when used with SSRIs, affects BIS monitoring. It’s a must-read for anyone keen on understanding nuanced pharmacological interactions.

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Where new CRNAs stumble on QA
This discussion highlights the common pitfalls new CRNAs face with quality assurance processes. It’s a practical guide for those looking to navigate early career challenges smoothly.

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Ultrasound presets that speed regional starts
Members are sharing tips on ultrasound presets that can make regional anesthesia setups quicker and more efficient. A great conversation for anyone looking to optimize their workflow.

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Looking forward to another week of engaging discussions. Thanks for being a part of our community and contributing to these important conversations.

Had a case last week with a ketamine infusion on an SSRI patient where BIS sat in the 70s despite deep anesthesia — watch the raw EEG/EMG and hemodynamics, and ‘don’t chase the number’. If EMG is noisy, a quick forehead degrease and firmer sensor tape often knocks down spurious BIS by about 5–10 points, but consider entropy or PSI if it stays flaky.

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