Ketamine

Question 1

Ketamine Class

Answer 1

Anaesthetics, General > NMDA receptor antagonists

Question 2

Ketamine Presentation

Answer 2

Clear, colourless, aqueous solution. Vial 200mg in 20mL

Question 3

Ketamine Administration

Answer 3

Intravenous (IV)
Intraosseous (IO)

Question 4

Ketamine Indications

Answer 4

Adult and Paed:

Severe Pain
Procedural Sedation

Question 5

Ketamine Contra-indications

Answer 5

Acute porphyrias (rare enzyme disorder)
Pre-eclampsia
Eclampsia
Hypertension
Severe Cardiac Disease
Stroke
KSAR

Question 6

Ketamine Dose

Answer 6

Adult:
Pain: 0.1-0.3 mg/kg IV (rpt PRN, at not < 10 mins)
Procedural Sedation: 0.5 - 1 mg/kg IV (rpt PRN, at not < 10 mins)
5mg/kg IM

Paed:
Pain: 0.1 - 0.3 mg/kg IV (rpt x1 only, at not < 10 mins)
Procedural Sedation: 0.5 - 1 mg/kg IV/IO (repeatable at > 10 min intervals)
4-5 mg/kg IM

Question 7

Ketamine Pharmacology

Answer 7

Induces Sedation, immobility amnesia, and marked analgesia

Question 8

Ketamine Side Effects

Answer 8

Diplopia
Hallucinations
Hypertension
Nausea and Vomiting
Tachycardia
Transient Psychotic effects

Uncommon:
Arrhythmias / Bradycardia / Hypotension / Laryngospasm / Respiratory Depression

Question 9

Ketamine Additional Info

Answer 9

Incidents of hallucinations, nightmares, and other psychotic effects can be reduced by a Benzodiazepine such as Diazepam or Midazolam.
Reduces Morphine Requirements.
Has low frequency of serious side effects in doses used for analgesia.
Allows patients to maintain their pharyngeal reflexes and maintain their own airway.
Controlled under Sec 3 Misuse of Drugs Act 1988