KETAMINE
It induces a so called dissociative anaesthesia-profound analgesia, immobility, amnesia with light sleep and feeling of dissociation from ones own body and the surroundings. The primary site of action is in the cortex & subcortical areas. Respiration is not depressed, reflaxes are not abolished and muscle tone increases. Heart rate, cardiac output and BP are elevated due to sympathetic stimulation. Children tolerate the drug better.For operations on the head & neck, in patients who have bled, in those who do not want to lose consciousness & for short operations. Burn dressing. Anaesthetic for diagnostic & surgical procedures. To supplement low potency agents like nitrous oxide.
I.V. : 1-4.5 mg/kg (av : 2 mg/kg or I.M. : 6.5-13 mg per kg (av: 10 mg/kg). Maint. : Increment of 50% of the full induction dose repeatedly.
Increased intracranial or intraocular pressure. Psychiatric disorders. Cardiovascular disease such as uncontrolled hypertension, unstable angina or recent myocardial infarction, right or left heart failure, aneurysms.
Rapid injection or overdosage may cause respiratory depression. Post operative confusional states may occur. Periodic assessment of cardiovascular functions. Alcohol intoxicated patients. Increased CSF & intraocular pressure. Paediatrics: Adjust dose as per body weight. Pregnancy: Use with caution. Lactation: Use with caution. Elderly: Adjust dose as per body weight.
Hypotension, Increased BP, pulse rate, bradycardia, arrhythmia, respiratory depression, illusions, vivid dreams, hallucinations diplopia, nystagmus, clonic & tonic movements, anorexia, nausea, vomiting.
Pancuronium, oxytocin, ergometrine potentiate cardiovscular adverse effects. Concurrent administration with aminophylline reduces seizure threshold, benzodiazepines reduce incidence and severity of psychotomimetic and cardiovascular responses.
