Indication

Ketamine Hydrochloride injection is indicated as the sole anesthetic agent for diagnostic and surgical procedures that do not require skeletal muscle relaxation. Ketamine Hydrochloride injection is best suited for short procedures, But it can be used, with additional doses, for longer procedures. Specific areas of application have included the following:
1. Debridement, painful dressings, and skin grafting in burn patients, as well as other superficial surgical procedures.
2. Neurodiagnostic procedures such as pneumonencephalograms, ventriculograms, myelograms, and lumbar punctures.

3. Diagnostic and operative procedures of the eye, ear, nose and mouth, including dental extractions.

Ketamine Hydrochloride injection is indicated for the induction of anesthesia prior to the administration of other general anesthetic agents. Ketamine Hydrochloride injection is indicated to supplement low-potency agents, such as nitrous oxide.


Dosage & Administration

Onset and Duration: Because of rapid induction following the initial intravenous injection, the patient should be in a supported position during administration. The onset of action of Ketamine is rapid, an intravenous dose of 2 mg/kg of body weight usually produces surgical anesthesia within 30 seconds after injection, with the anesthetic effect usually lasting 5 to 10 minutes. If a longer effect is desired, additional increments can be administered intravenously or intramuscularly to maintain anesthesia without producing significant cumulative effects. Intramuscular doses, from experience primarily in children, in a range of 9 to 13 mg/kg usually produce surgical anesthesia within 3 to 4 minutes following injection, with the anesthetic effect usually lasting 12 to 25 minutes.


Precautions

Ketamine should be used by or under the direction of physicians experienced in administering general anesthetics and in maintenance of an airway and in the control of respiration. Because pharyngeal and laryngeal reflexes are usually active, Ketamine should not be used alone in surgery or diagnostic procedures of the pharynx, larynx, or bronchial tree. Mechanical stimulation of the pharynx should be avoided, whenever possible, if Ketamine is used alone. The intravenous dose should be administered over a period of 60 seconds. More rapid administration may result in respiratory depression or apnea and enhanced pressor response. In surgical procedures involving visceral pain pathways, Ketamine should be supplemented with an agent which obtunds visceral pain.

Usage in Pregnancy

Since the safe use in pregnancy, including obstetrics (either vaginal or abdominal delivery), has not been established, such use is not recommended.


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