ketamine 10 mg/mL hydrochloride ( KETALAR )
ketamine 10 mg/mL is a rapid-acting general anesthetic producing an anesthetic state characterized by profound analgesia, normal pharyngeal-laryngeal reflexes, normal or slightly enhanced skeletal muscle tone, cardiovascular and respiratory stimulation, and occasionally a transient and minimal respiratory
depression. The mechanism of action is primarily due to antagonism of N-methyl-D-aspartate (NMDA receptors) in the central nervous system.
Class: General Anesthetic
Indications: Induction and maintenance of general anesthesia.
Unlabeled: Analgesia, sedation Available dosage form in the hospital: Solution, Injection: 10 mg/mL (20 mL); 50 mg/mL (10
Dosage: May be used in combination with anticholinergic agents to decrease hypersalivation.
Note: Titrate dose for desired effect.
Sedation/analgesia (unlabeled use):
I.M.: 2-4 mg/kg (White, 1982)
I.V.: 0.2-0.75 mg/kg (White, 1982)
Continuous I.V. infusion: 2-7 mcg/kg/minute (Hocking, 2003; Remérand, 2009; Zakine, 2008)
Critically-ill patients: Loading dose: 0.1-0.5 mg/kg; followed by 0.83-6.7 mcg/kg/minute (equivalent to 0.05-0.4 mg/kg/hour) (Barr, 2013)
Induction of anesthesia (unlabeled dosing):
I.M.: 4-10 mg/kg (Green, 1990; Miller, 2010; White, 1982)
I.V.: 0.5-2 mg/kg (Miller, 2010; White, 1982)
Maintenance of anesthesia:
May administer supplemental doses of one-half to the full induction dose or a continuous infusion of 0.1-0.5 mg/minute (per manufacturer). Note: To maintain an adequate concentration of ketamine for maintenance of anesthesia, 1-2 mg/minute has been recommended (White, 1982); doses in the range of 15-90
mcg/kg/minute (~1-6 mg/minute in a 70–kg patient) have also been suggested (Miller, 2010). Concurrent use of nitrous oxide reduces ketamine requirements.
Some other effects less often reported were: