Induction of anesthesia
Ketamine is recommended for:
- As the sole anesthetic agent for diagnostic and surgical procedures that do not require skeletal muscle relaxation. Ketamine is best suited for short procedures and it can be used with additional doses, for longer procedures.
- For the induction of anesthesia prior to the administration of other general anesthetic agents.
- To supplement low-potency agents, such as nitrous oxide.
Adult:
General Anesthesia-
- IV Induction: 1-4.5 mg/kg single dose
- IM Induction: 6.5-13mg
- IV Infusion: 1-2mg/kg at 0.5mg/kg/min
Maintenance: The maintenance dose should be adjusted according to the patient’s anesthetic needs and whether an additional anesthetic is employed. Increments of one-half to the full induction dose may be repeated as needed for maintenance of anesthesia.
Rapid sequence Intubation, Induction – 2mg/kg IV
Pediatric:
General Anesthesia:
- IV Induction: 1-2 mg/kg IV; range: 4-13 mg/kg
- IM Induction: 5-10 mg/kg; range: 0.5-4.5 mg/kg
- Maintenance: 0.01-0.03 mg/kg/min continuous IV infusion
Maintenance: The maintenance dose should be adjusted according to the patient’s anesthetic needs and whether an additional anesthetic is employed. Increments of one-half to the full induction dose may be repeated as needed for maintenance of anesthesia.
The 100 mg/ml concentration of ketamine should not be injected intravenously without proper dilution. It is recommended the drug be diluted with an equal volume of either Sterile Water for Injection, USP, Normal Saline, or 5% Dextrose in Water.
Lactation: Ketamine is likely to be excreted in breast milk and therefore breastfeeding should be discontinued when ketamine is in use.
Management: Employ supportive ventilation. Mechanical support of respiration is preferred to admin of analeptics.