• 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

• 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 5 to 20 micrograms/kilogram/minute or repeated as required

Continuous I V Infusion:
500 mg in 50 ml D5W or NS

Intermittent IV Infusion:
Dilute in D5W or NS to a maximum concentration 5 mg/ml.

• 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

• 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

BP

HR

respiratory rate

oxygen saturation; blood gases

skeletal muscle tone

presence of emergence reactions

level of consciousness

adequacy of pain control

• IV direct must be administered by a physician.
• May be administered by IV infusion by an approved nurse in CCTC.
• Continuous infusion must be administered via an infusion pump.
• For continuous infusions, placement of an arterial line for blood pressure monitoring is preferred.