• 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