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Indications & Uses
Kain (ketamine hydrochloride) is used as the only anesthetic for diagnostic and surgical procedures that don't need skeletal muscle relaxation. Kain injection suits short procedures best, but with additional doses it can also be used for longer ones. Specific areas where it has been used include the following. Debridement, painful dressings and skin grafting in burn patients, as well as other superficial surgical procedures. Neurodiagnostic procedures such as pneumonencephalograms, ventriculograms, myelograms and lumbar punctures. Diagnostic and operative procedures of the eye, ear, nose and mouth, including dental extractions. Kain injection is also used to start (induce) anesthesia before other general anesthetic agents are given. It can be used as well to supplement low-potency agents, such as nitrous oxide.
Pharmacology
Ketamine is a rapid-acting general anesthetic that is not a barbiturate. It produces an anesthetic state with profound analgesia. This state is called "dissociative anesthesia", a form of general anesthesia marked by catalepsy, catatonia and amnesia, though the person is not necessarily completely unconscious.
Ketamine is often called a "unique drug". It has hypnotic (sleep producing), analgesic (pain relieving) and amnesic (short term memory loss) effects, and no other drug used in clinical practice combines these three important features. It was first used clinically in 1970, and because of these combined effects people thought it might be the perfect anesthetic agent.
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
Onset and Duration: Induction is rapid after the first intravenous injection, so the patient should be in a supported position while Ketamine is given. The onset of action is quick. An intravenous dose of 2 mg/kg of body weight usually produces surgical anesthesia within 30 seconds of the injection, and the effect usually lasts 5 to 10 minutes. If a longer effect is wanted, further increments can be given intravenously or intramuscularly to maintain anesthesia without significant cumulative effects. Intramuscular doses of 9 to 13 mg/kg (this comes from experience mainly in children) usually produce surgical anesthesia within 3 to 4 minutes of injection, with the effect usually lasting 12 to 25 minutes.
Intravenous Route: The first intravenous dose of Ketamine may range from 1 mg/kg to 4.5 mg/kg. The average amount needed for 5 to 10 minutes of surgical anesthesia has been 2 mg/kg. In adults, an induction dose of 1 mg to 2 mg/kg of intravenous Ketamine at a rate of 0.5 mg/kg/mm may be used to induce anesthesia. Diazepam in doses of 2 mg to 5 mg may also be used, given in a separate syringe over 60 seconds. In most cases 15 mg of intravenous diazepam or less will be enough. This induction dosage program may reduce psychological manifestations during emergence, particularly dream-like observations and emergence delirium.
Rate of Administration: Ketamine should be given slowly, over a period of 60 seconds. Faster administration may cause respiratory depression and an enhanced pressor response.
Intramuscular Route: The first intramuscular dose of Ketamine may range from 6.5 to 13 mg/kg. A dose of 10 mg/kg will usually produce 12 to 25 minutes of surgical anesthesia.
Maintenance of anesthesia: Increments of one half to the full induction dose, given either IV or IM, may be repeated as needed to maintain anesthesia. Nystagmus, movements in response to stimulation, and vocalization may show that the anesthesia is getting lighter.
Side Effects
Cardiovascular: Blood pressure and pulse rate often go up after Kain is given on its own. But low blood pressure (hypotension) and a slow pulse (bradycardia) have also been seen, and arrhythmia has occurred too. Respiration: Breathing is often stimulated. Still, severe depression of respiration or apnea may occur if high doses of Kain are given rapidly by the intravenous route. Laryngospasms and other forms of airway obstruction have happened during Kain anesthesia. Eye: Diplopia and nystagmus have been noted after Kain is given. It may also cause a slight rise in intraocular pressure measurement. Neurological: In some patients, skeletal muscle tone may increase, and this can show as tonic and clonic movements that sometimes look like seizures. Gastrointestinal: Anorexia, nausea and vomiting have been observed, but this is not usually severe.
Cautions & Contraindications
Warnings & Precautions
Kain should be given only by physicians, or under their direction, who are experienced in giving general anesthetics, keeping an airway open and controlling respiration. The pharyngeal and laryngeal reflexes are usually still active, so Kain should not be used alone in surgery or diagnostic procedures of the pharynx, larynx or bronchial tree. If Kain is used alone, avoid mechanical stimulation of the pharynx whenever possible. Give the intravenous dose over 60 seconds. Faster administration may cause respiratory depression or apnea, and a stronger pressor response. In surgical procedures that involve visceral pain pathways, Kain should be supplemented with an agent that obtunds visceral pain.
Contraindications
Ketamine should not be given to people whose blood pressure rising significantly would be a serious danger, or to anyone who has shown hypersensitivity to the drug.
Pregnancy & Breastfeeding
Ketamine hydrochloride hasn't been shown to be safe in pregnancy, and that includes obstetric use, whether for a vaginal or an abdominal delivery. So it is not recommended in these situations.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Overdose
Giving Ketamine Hydrochloride too much, or giving it too quickly, can cause respiratory depression. If this happens, the patient's breathing should be supported with ventilation. Mechanical support of breathing is preferred over giving analeptics.
Ketamine Hydrochloride has a wide margin of safety. There have been several cases where people were given an overdose by mistake (up to 10 times the usual required dose), and they recovered completely, though recovery took longer than usual.
⚠️ In an emergency call 999 or go to the nearest hospital emergency department.
Storage
Keep Ketamine Hydrochloride in a cool, dry place and protect it from light. Keep it out of the reach of children.
Common questions about Ketalar 50 mg/ml
What is Ketalar 50 mg/ml IM/IV Injection?
Ketalar 50 mg/ml IM/IV Injection is a medicine that contains Ketamine Hydrochloride. It is made by Popular Pharmaceuticals PLC. It belongs to the General (Intravenous) anesthetics group of medicines.
What is Ketalar used for?
Kain (ketamine hydrochloride) is used as the only anesthetic for diagnostic and surgical procedures that don't need skeletal muscle relaxation. Kain injection suits short procedures best, but with additional doses it can also be used for longer ones.
What are the side effects of Ketalar?
Cardiovascular: Blood pressure and pulse rate often go up after Kain is given on its own. But low blood pressure (hypotension) and a slow pulse (bradycardia) have also been seen, and arrhythmia has occurred too.
Can I take Ketalar during pregnancy or while breastfeeding?
Ketamine hydrochloride hasn't been shown to be safe in pregnancy, and that includes obstetric use, whether for a vaginal or an abdominal delivery. So it is not recommended in these situations. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
What happens if I take too much Ketalar?
Giving Ketamine Hydrochloride too much, or giving it too quickly, can cause respiratory depression. If this happens, the patient's breathing should be supported with ventilation. In an emergency call 999 or go to the nearest hospital emergency department.
How should I store Ketalar?
Keep Ketamine Hydrochloride in a cool, dry place and protect it from light. Keep it out of the reach of children.
Do I need a prescription for Ketalar?
Ketalar is a prescription (Rx) medicine. Take it as your doctor advises.