It is indicated As the sole anesthetic agent for diagnostic and surgical procedures that do not require skeletal muscle relaxation For the induction of anesthesia prior to the administration of other general anesthetic agents To supplement low-potency agents such as nitrous oxide
General (Intravenous) anesthetics
Ketamine is a rapid-acting, nonbarbiturate general anesthetic. It produces an anesthetic state characterized by profound analgesia. The anesthetic state produced by Ketamine has been termed "dissociative anesthesia" (A form of general anesthesia characterized by catalepsy, catatonia, and amnesia, but not necessarily involving complete unconsciousness).Ketamine is frequently described as a "unique drug" because it has hypnotic (sleep producing), analgesic (pain relieving) and amnesic (short term memory loss) effects- no other drug used in clinical practice combines these three important features. It was first used clinically in 1970, and because of these combined effects it was thought that it might be the perfect anesthetic agent.
Induction of anesthesia Intravenous injection: It should be administered slowly over a period of 60 seconds. The initial dose may range from 1 mg/kg to 4.5 mg/kg. The average amount required to produce 5 to 10 minutes of surgical anesthesia is 2 mg/kg. Intramuscular injection: The initial dose may range from 6.5 mg/kg to 13 mg/kg. A dose of 10 mg/kg will usually produce 12 to 25 minutes of surgical anesthesia. Intravenous infusion: A solution containing 1mg/ml with total dose of 0.5-2 mg/kg. Maintenance of Anesthesia: Intravenous and intramuscular injection: Increments of one half to the full induction dose may be repeated for maintenance of anesthesia. Intravenous infusion: 10-45 ?gm/kg/min,rate adjusted according to response.
Prolonged recovery time may occur if barbiturates and/or narcotics are used concurrently with Ketamine. Ketamine is clinically compatible with the commonly used general and local anesthetic agents when an adequate respiratory exchange is maintained.
Ketamine is contraindicated in patients with any condition in which a significant elevation of blood pressure would constitute serious hazard and in those who are hypersensitive to the drug or its components.
Treatment emergent adverse reactions are common during recovery for Ketamine anesthesia and often include unpleasant dreams,confusion,hallucination,delirium. Blood pressure and pulse rate are frequently elevated following administration of Ketamine. However,hypotension and bradycardia have been observed. Laryngospasm and other forms of airway obstruction have occurred during Ketamine anesthesia. In some patients,enhanced skeletal muscle tone may be manifested by tonic and clonic movements,sometimes resembling seizures. Anorexia,nausea and vomiting have also been observed.
The safety of Ketamine in pregnancy has not been established and such use is not recommended. Ketamine is likely to be excreted in breast milk and therefore breastfeeding should be discontinued when Ketamine is in use
Respiratory depression may occur with overdosage or too rapid a rate of administration of Ketamine, in which case supportive ventilation should be employed. Mechanical support of respiration is preferred to administration of analeptics. Ketamine has a wide margin of safety; several instances of unintentional administration of overdoses of Ketamine (up to 10 times the usually required dose) have been followed by prolonged but complete recovery.
Store in a cool dry place protected from light. Keep out of rich of children.
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