Ketamine (Ketalar)

• Medication used especially for deep sedation in pediatric patients.

• Not a primary use drug.

• Administer drug only with previous experience or under the direction of a provider familiar with its use.

Mechanism of Action

Selectively interrupts cerebral pathways, causing dissociative anesthesia.

Dosage and Administration

• Usually 0.25 to 1.0 mg/kg. 

• Dose is based on patient response to medication.

• Rate of infusion should not exceed 50 mcg/kg/min.

Adverse Reactions

• Respiratory effects – bradypnea, dyspnea, respiratory depression, apnea, bronchial smooth muscle relaxation, increased tracheo-bronchial tree secretions

• Cardiovascular effects – bradycardia, tachycardia, hypertension, hypotension, arrhythmias

• Musculoskeletal – enhanced skeletal tone

• CNS  – uncontrolled muscle movements, visual illusions

• GI – vomiting, increased salivary secretions

• Special considerations – monitor patient for emergent reactions including vivid dreams, or hallucinations. Consider premedication (midazolam) to reduce potential for symptoms.