Ketamine

Ketamine is a dissociative anesthetic agent used for induction and maintenance of general anesthesia, sedation, and analgesia.

See: induction agents, maintenance of anesthesia, and sedation agents?

Uses, Dosing, & Administration

Induction of anesthesia:

• IV over 30 to 60 seconds 1 to 2 mg/kg (LBW)
  • 0.5 to 1 mg/kg in patients with shock
• IM 4 to 6 mg/kg

Maintenance of anesthesia (adjunct to TIVA or inhalational anesthesia)

Various regimens exist:

• 0.075 mg/kg at incision followed by

• 0.25 to 0.35 mg/kg at incision, followed by continuous infusion up to 1 mg/kg/hour

Contraindications, Warnings, & Interactions

Precautions

ith cardiogenic shock caused by myocardial ischemia because the increases in HR and BP may detrimentally unbalance myocardial oxygen supply versus demand. Also, the sympathomimetic effects of ketamine may detrimentally increase pulmonary artery pressure (PAP) in patients with pulmonary hypertension or right-sided heart failure.

Adverse Effects

Myocardial ischemia, PAP, CBF

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