KETAMINE

Dosage form: Vials, 50 mg/mI10 mI

Uses: Ketamine hydrochloride is given intravenously or intramuscularly for surgical anaesthesia. Ketamine hydrochloride produces dissociative anaesthesia characterised by catalepsy; amnesia, and .marked analgesia which may persist into the recovery period. There is often an increase in muscle tone and the patient's eyes may remain open for all or part of the period of anaesthesia. It may be administered by intravenous or intramuscular injection.

Administration: A dose equivalent to 2 mg of Ketamine per kg body-weight given intravenously over 60 seconds usually produces surgical anaesthesia within 30 seconds and lasting for 5 to 10 minutes; an intramuscular dose equivalent to 10 mg of Ketamine per kg usually produces surgical anaesthesia within 3 to 4 minutes lasting for 12 to 25 minutes. Additional doses may be given for maintenance. Ketamine is also given by intravenous infusion.
Ketamine is used for anaesthesia for diagnostic or short surgical operations, for the induction of anaesthesia to be maintained with other agents, and as a supplementary anaesthetic. Administration should be preceded by atropine or another suitable antimuscarinic agent. Diazepam or another benzodiazepine may be given before surgery or as an adjunct to Ketamine to reduce the incidence of emergence reactions.

Observe
Adverse Effects: Emergence reactions are common during recovery from Ketamine anaesthesia and include vivid often unpleasant dreams, confusion, hallucinations, and irrational behavior that respond if necessary to an intravenous benzodiazepine or similar agent. Children and elderly patients appear to be slightly less sensitive than other adult patients. Patients may also experience increased muscle tone, sometimes resembling seizures. Blood pressure and heart-rate may be temporarily increased by Ketamine but hypotension, arrhythmias, and bradycardia have occurred rarely.
The respiration may be depressed following rapid intravenous injection or with high doses. Apnoe and laryngospasm have occurred. Diplopia and nystagmus may occur. Nausea and vomiting, lachrymation, hypersalivation, and raised intraocular and cerebrospinal fluid pressure, have also been reported. Transient skin rashes and pain at the site of injection may occur.

Storage: Store in a cool and dry place, away from light. Keep out of reach of children.