Ketamine: Difference between revisions
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* Analgesia[[CiteRef::silverstein2021ke]] |
* Analgesia[[CiteRef::silverstein2021ke]] |
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** Intermittent: |
** Intermittent: start at 0.1 mg/kg IV q4h, and titrate (max 0.35 mg/kg) |
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** Continuous infusion: 0.1 mg/kg/h IV infusion (max 0.25 mg/kg/h) |
** Continuous infusion: start at 0.1 mg/kg/h IV infusion, and titrate (max 0.25 mg/kg/h) |
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* Dissociative anesthesia: ≥1 mg/kg |
* Dissociative anesthesia: ≥1 mg/kg |
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Latest revision as of 12:55, 2 November 2021
Background
- Phencyclidine (PCP) derivative
- Inhibits NMDA (N-methyl-d-aspartate) receptors
- Dose-dependent effects: low doses are primarily analgesic, while high doses cause dissociative anesthesia
- When used for management of acute pain, can be opioid-sparing
Dosing
- Analgesia1
- Intermittent: start at 0.1 mg/kg IV q4h, and titrate (max 0.35 mg/kg)
- Continuous infusion: start at 0.1 mg/kg/h IV infusion, and titrate (max 0.25 mg/kg/h)
- Dissociative anesthesia: ≥1 mg/kg
Hepatic Dosing
- Avoid in liver dysfunction
Safety
- Avoid in patients with psychosis, severe cardiovascular disease, or liver dysfunction
Adverse Effects
- Primarily dose-dependent, with nausea, vomiting, vivid dreams, hallucinations, and dissociation seen at high doses
Pregnancy
- Unclear safety in pregnancy
References
- ^ silverstein2021ke
