| Name: |
KETAMINE (KetalarR) |
| Classification: |
cataleptic, analgesic and anesthetic agent
- produces an anesthetic state characterized by profound analgesia, but without any sedation, hypnosis or effect on pharyngeal laryngeal reflexes
- reduces lower airway resistance and increases lung compliance in patients with bronchospasm
- has been used as adjunct to difficult or painful examinations and procedures
|
| Dose: |
- for induction of anesthesia:
- 1.0-2.0 mg/kg IV bolus over 1-2 minutes, or 4-8 mg/kg IM; 50% of induction dose repeated as necessary for maintenance of anesthesia (q5-30 min)
- for treatment of bronchospasm:
- 1.0-2.0 mg/kg induction followed by 0.1-0.5 mg/min maintenance infusion
- for sedation and analgesia during procedures:
- 0.2 to 1.0 milligram/kilogram over 2 to 3 minutes, followed by continuous infusion of 0.3 - 1.2 mg/kg/hr as required
|
| Administration: |
Continuous I V Infusion:
500 mg in 50 ml dextrose 5% or sodium chloride 0.9%
Intermittent IV Infusion:
Dilute in dextrose 5% or sodium chloride 0.9% to a maximum concentration 5 mg/ml.
|
| Adverse Effects: |
- purposeless movements of extremities (not indicative of level of anesthesia)
- increased BP
- increased HR
- vivid dreams, with confusion or hallucinations, particularly during emergence from anesthesia; can be decreased with diazepam or decreasing sensory load
- increased salivation; can be decreased with atropine or scopolamine
- respiratory depression, mainly with too rapid administration
- increased cerebral spinal fluid pressure
- nausea/vomiting
- increased intraocular pressure
|
| Drug Interactions: |
- ketamine + barbiturates = prolonged recovery time from ketamine
- ketamine + narcotics = prolonged recovery time from ketamine
- ketamine + atracurium = increased neuromuscular blockade
- ketamine + theophylline = possible decrease in seizure threshold
|
| Monitoring Therapy: |
- blood pressure
- heart rate
- respiratory rate
- oxygen saturation; blood gases
- skeletal muscle tone
- presence of emergence reactions
- level of consciousness
- adequacy of pain control
|
| Adult Critical care Protocol: |
- May be administed IV direct or by IV infusion by a nurse in Adult Critical Care
- Continuous infusions must be administered by infusion device with pump library enabled.
|
