Composition
Inj: Per ml: Ketamine hydrochloride 50 mg; 2 ml(100 mg), 5 ml(250 mg), 10 ml(500 mg); vial.
Indications & Dosage
Induction and maintenance of anaesthesia for short procedures: BY IM INJ: Adult: Initially 6.5-13 mg/kg, adjusted according to response, a dose of 10 mg/kg usually produces 12-25 minutes of surgical anaesthesia. Children: 3-7 mg/kg, adjusted according to response BY IV INJ: Adult: Initially 1-4.5 mg/kg, adjusted according to response, to be administered over at least 60 seconds, a dose of 2 mg/kg usually produces 5-10 minutes of surgical anaesthesia. Children: use smaller doses (0.5-1 mg/kg) for sedation for minor procedures; usual induction dosage: 1-2 mg/kg. Diagnostic manoeuvres and procedures not involving intense pain: BY IM INJ: Adult: Initially 4 mg/kg. Induction and maintenance of anaesthesia for long procedures: BY IV INF: Adult: Initially 0.5-2 mg/kg, using an INF solution containing 1 mg/ml; maintenance 10-45 mcg/kg/minute, adjusted according to response. Children: Sedation: 5-20 mcg/kg/min; start at lower dosage listed & titrate to effect.
Administration
Do not exceed 0.5 mg/kg/min or administer faster than 60 seconds; do not exceed final concentrations of 2 mg/ml; dilute for IV administration with NS, SWFI, or D5W.
Contraindications
Acute porphyrias, eclampsia, pre-eclampsia, head trauma, hypertension, raised intracranial pressure, severe cardiac disease, stroke
Precautions
Cardiovascular disease, acute circulatory failure (shock), dehydration, elderly, fixed cardiac output, hallucinations, head injury, hypertension, hypovolaemia, increased cerebrospinal fluid pressure, intracranial mass lesions, nightmares, predisposition to seizures, psychotic disorders, raised intra-ocular pressure, respiratory tract infection, thyroid dysfunction. Rapid administration or overdose may cause respiratory depression.
Pregnancy
Caution; may depress neonatal respiration if used during delivery
Lactation
Avoid for 12 hrs after last dose
Side Effects
Arrhythmias, diplopia, hallucinations, hypertension, hypotension, nausea, nightmares, nystagmus, rash, tachycardia, transient psychotic effects, vomiting, bradycardia, laryngospasm, respiratory depression, apnoea, cystitis, haemorrhagic cystitis, hypersalivation, insomnia, raised intra-ocular pressure