Essay on Ketamine

957 Words Nov 1st, 2012 4 Pages
Ketamine
Description: Ketamine is a nonbarbiturate, sedative hypnotic used parenterally to provide anesthesia for short diagnostic and surgical procedures. It is also used as an inducing agent, as an adjunct to supplement low-potency anesthetics such as nitrous oxide, and as a supplement to local and regional anesthesia. Ketamine can be used concomitantly with muscle relaxants without complication because it does not provide muscle relaxation of its own. It is a fairly short-acting agent that provides a profound, rapid, dissociative state and a short recovery time. Mechanism: Although the exact mechanism of action is not known, ketamine appears to be an agonist at CNS muscarinic acetylcholine-receptors and opiate-receptors. Ketamine
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More rapid administration can result in respiratory depression, apnea, and an enhanced pressor response. Usual induction doses are 1 - 2 mg/kg IV and will produce 5 - 10 minutes of surgical anesthesia.
Intramuscular dosage is 3 - 7 mg/kg IM, which will produce 12 - 25 minutes of surgical anesthesia. For intramuscular injection, no dilution is necessary and the standard procedures for IM injection should be followed, such as injecting into a large muscle mass and aspiration prior to injection to avoid injection into a blood vessel.
For general anesthesia maintenance: 50 - 100% of the full IV or IM induction dose can be repeated as needed.
Ketamine can be used for sedation before minor procedures, although this use is not approved by the FDA
The oral dosage would be 6 - 10 mg/kg PO (mixed in cola or other beverage) given 30 minutes before procedure.
The intravenous dosage in this case is 0.5 - 1 mg/kg IV (range: 0.5 - 2 mg/kg).
In any usage, ketamine should be given on an empty stomach to help prevent possible vomiting and aspiration.
Tolerance:
There is some evidence in the literature that repeated use can result in tolerance, requiring higher doses with successive administrations to achieve the same levels of sedation and anesthesia. Ketamine is contraindicated in patients with hypertension, cardiac disease, myocardial infarction, congestive heart failure, stroke, head trauma or intracranial mass, or intracranial bleeding, or in other patients

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