KETAMINE injectable

Prescription under medical supervision

Therapeutic action

– General anaesthetic

Indications

– Induction and maintenance of general anaesthesia

Forms and strengths, route of administration

– 250 mg in 5 ml ampoule (50 mg/ml) for IM, IV injection or infusion

Dosage

Child and adult:

– Induction
• IV: 2 mg/kg to be injected slowly. Anaesthesia is produced within one minute and lasts 10 to 15 minutes.
• IM: 8 to 10 mg/kg. Anaesthesia is produced within 5 minutes and lasts 15 to 30 minutes.

 Maintenance
• IV: 0.5 to 1 mg/kg depending on recovery signs (approximately every 15 minutes)
• IM: 5 mg/kg approximately every 20 to 30 minutes

Duration

– Depending on duration of the operation

Contra-indications, adverse effects, precautions

– Do not administer to patients with intraocular hypertension, pre-eclampsia.
– Administer with caution to patients with arterial or intracranial hypertension, coronary insufficiency, psychiatric disorders.
– May cause: hypertension, hypersalivation, hallucinations during recovery (less frequent in children or when injected IM), apnoea following rapid IV injection.
– Premedication to prevent hypersalivation and hallucinations:
• atropine IV: 0.01 to 0.015 mg/kg + diazepam slow IV: 0.1 mg/kg, during induction
or
• atropine IM: 0.01 to 0.015 mg/kg + diazepam IM: 0.1 mg/kg, 30 minutes before induction
– Technical equipment for intubation and ventilation must be available and ready for use.
– Pregnancy: no contra-indication, except in pre-eclampsia. For ceaserean sections, do not exceed 1 mg/kg by IV injection (risk of neonatal respiratory depression at higher doses).
– Breast-feeding: no contra-indication

Remarks

– Ketamine has no muscle relaxant properties.
– In some countries, ketamine is on the list of narcotics: follow national regulations.
– Also comes in 10 ml ampoule containing 500 mg (50 mg/ml).
– Storage: below 25 °C -