Ketamine

Indications:-
 General anaesthesia – either alone or in combination with
other medications.
 Short-term medical procedures that do not require skeletal
muscle relaxation.
 Induction of general anesthesia as a pre-anesthetic to
other general anesthetic agents.
 Supplementing low-potency agents such as nitrous oxide.
 Short-term procedural sedation such as the reduction of
fractures/dislocations, wound repair in uncooperative
patients and rapid sequence intubation(emergency dept.)
 Medication of choice for patients for patients with
bronchospasm because of its bronchodilatory properties.

Dosage:-
Adult(16 years or older)
 Loading dose
 IV : 1-4.5 mg/kg slow IV
once
 Alternatively(off-label):
0.5-2mg/kg slow IV if
Paediatrics(Only 3 months or
older)
 IV
 1.5-2 mg/kg over 30-60
sec; may administer
incremental doses of 0.5-
2mg/kg IV PRN if initial
 adjuvant drugs(e.g., sedation inadequate OR
midazolam) are used  0.25-0.5 mg/kg
 IM : 6.5-13 mg/kg once
 Alternatively(off-label): 4-  IM
10 mg/kg IM once if  4-5 mg/kg IM once, may
adjuvant drugs(e.g., give a repeat dose(range
midazolam) are used 2-5mg/kg) if sedation
 Maintenance inadequate after 5-10 min
 50% of IV Ketamine or if additional doses are
induction dose required
administered PRN OR  Oral
 0.1-0.5 mg/min IV  6-10 mg/kg PO once; mix
continuous infusion with 0.2-0.3 ml/kg of a
beverage; give 30 min
before procedure

Contraindications:-
Ketamine is contraindicated with underlying conditions in
which increased blood pressure would pose a risk of
complications such as aortic dissection, uncontrolled
hypertension, myocardial infarction or aneurysms.
 Prior hypersensitivity to the drug
 During obstetrics, pregnancy or breastfeeding
 Intoxicated with ethanol due to additive sedation
 Schizophrenia(Exacerbation)