GuidelinesOther guideline
Infusion: Ketamine
Ketamine Infusion
| Trade names: | Presentation and strength: |
| Ketalar. Brevinase. | 200mg/20ml vial (10mg/ml). 500mg/10ml vial (50mg/ml). 1000mg/10ml vial (100mg/ml). |
| Cautions: see SAMF. Ketamine is supplied in different concentrations. Ensure that you are working with the correct concentration to avoid major drug error. Use 100mg/ml or 50mg/ml vials for mixing 50ml infusions. Low-dose midazolam with ketamine has been described to treat and/or prevent emergence delirium. The mixture of ketamine and midazolam is safe and stable when mixed in the same syringe, and is an internationally accepted practice. | |
| Loading dose: | |
| Adult: IV anaesthetic induction: 2mg/kg; For IM anaesthesia induction: 5mg/kg (onset 5 min). For procedural sedation and analgesia (PSA): 0.5 – 1 mg/kg IV | Paediatric: As for adult. |
| Commonly for 70kg adult: IV anaesthetic induction: 140mg. Usually 100 to 150mg IM anaesthesia induction: 350mg. PSA: 35-70mg IV | Neonatal: As for paediatric. |
| Constant infusion: | |
| Adult dosage range: For anaesthesia: ketamine 4mg/kg/hr. (Consider adding low-dose midazolam at 0.1mg/kg/hr.) For PSA: ketamine 2mg/kg/hr (midazolam 0.05mg/kg/hr.) | Paediatric dosage range: As for adult. |
| Neonatal dosage range: As for paediatric. | |
| Regime for 70kg adult: | Regime for paediatrics: |
| Mixture: 800mg ketamine (+ 20mg midazolam) in 50ml total volume. | Mixture: 200mg ketamine (+ 5mg midazolam) in 50ml total volume. |
| Rate: Run at 0.25ml/kg/hr for anaesthesia. Run at 0.125ml/kg/hr for sedation. Usually about 20ml/hr for anaesthesia and about 10ml/hr for sedation. | Rate: Run at 1ml/kg/hr for anaesthesia. Run at 0.5ml/kg/hr for sedation. |
| Alternative adult regime: | Alternative paediatric regime: |
| Mixture: | Mixture:For PSA : IM: 4 mg/kg or Oral: 4-5 mg/kg |
| Rate: | Rate: |
| Additional notes: Must use 50mg/ml or 100mg/ml multi-dose vials to mix infusions, must have these in stock. | -- |