Ketamine - Revision history

Danbot: Strip excess bold

2026-03-22T09:12:09Z

Strip excess bold

← Revisión anterior		Revisión del 09:12 22 mar 2026
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	==Adult Dosing==		==Adult Dosing==
	===Procedural Sedation or Induction===		===Procedural Sedation or Induction===
	~~'''~~Options:~~'''~~		Options:
	*1-2 mg/kg IV, followed by 0.5-1 mg/kg IV PRN		*1-2 mg/kg IV, followed by 0.5-1 mg/kg IV PRN
	*4-5 mg/kg IM → repeat 2-4 mg/kg IM after 10 min if first dose unsuccessful		*4-5 mg/kg IM → repeat 2-4 mg/kg IM after 10 min if first dose unsuccessful
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	==Pediatric Dosing==		==Pediatric Dosing==
	===Procedural Sedation or Induction===		===Procedural Sedation or Induction===
	*1.5-2 mg/kg IV ~~'''~~OR~~'''~~		*1.5-2 mg/kg IV OR
	*4-5 mg/kg IM<ref>Green S. et al. What is the optimal dose of intramuscular ketamine for pediatric sedation?. Acad Emerg Med. 1999 Jan;6(1):21-6</ref> ~~'''~~OR~~'''~~		*4-5 mg/kg IM<ref>Green S. et al. What is the optimal dose of intramuscular ketamine for pediatric sedation?. Acad Emerg Med. 1999 Jan;6(1):21-6</ref> OR
	*3-6 mg/kg IN<ref>Hall, D, et al. Intranasal ketamine for procedural sedation. Emerg Med J. 2014; 31:789-90.</ref> ~~'''~~OR~~'''~~		*3-6 mg/kg IN<ref>Hall, D, et al. Intranasal ketamine for procedural sedation. Emerg Med J. 2014; 31:789-90.</ref> OR

	==Special Populations==		==Special Populations==
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	===Neurologic Injury===		===Neurologic Injury===
	*Metaanalysis has shown that when ketamine is used in the presence of controlled ventilation, in conjunction with anaesthetics which reduce cerebral metabolism such as GABA receptor agonists, ~~'''~~ICP is not increased~~'''~~.<ref>Himmelseher S. et al. Revising a dogma: ketamine for patients with neurological injury? Anesth Analg. 2005 Aug;101(2):524-34 [http://www.researchgate.net/publication/7708550_Revising_a_dogma_ketamine_for_patients_with_neurological_injury/file/72e7e529656bccca4f.pdf PDF]</ref>		*Metaanalysis has shown that when ketamine is used in the presence of controlled ventilation, in conjunction with anaesthetics which reduce cerebral metabolism such as GABA receptor agonists, ICP is not increased.<ref>Himmelseher S. et al. Revising a dogma: ketamine for patients with neurological injury? Anesth Analg. 2005 Aug;101(2):524-34 [http://www.researchgate.net/publication/7708550_Revising_a_dogma_ketamine_for_patients_with_neurological_injury/file/72e7e529656bccca4f.pdf PDF]</ref>

	==Pharmacology==		==Pharmacology==

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2026-03-20T21:55:48Z

Switch SMW query from broadtable to table format for better layout with TOC

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2026-03-20T17:23:46Z

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Danbot: Add dynamic SMW Indications by Condition table (auto-populated from disease pages via MedicationDose template)

2026-03-20T16:41:54Z

Add dynamic SMW Indications by Condition table (auto-populated from disease pages via MedicationDose template)

@@ Línea 99: / Línea 99: @@
 *Causes sympathetic drive leading to hypertension and tachycardia
 **Caution in those with HTN or at risk for CAD<ref>Green SM, Roback MG, Kennedy RM, Krauss B. Clinical practice guideline for emergency department ketamine dissociative sedation: 2011 update. Ann Emerg Med. 2011;57(5):449-461. doi:10.1016/j.annemergmed.2010.11.030 [PubMed 21256625]</ref>
 ==See Also==

Rossdonaldson1: /* References */

2022-12-14T21:58:07Z

References

← Revisión anterior		Revisión del 21:58 14 dic 2022
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	[[Category:Pharmacology]] [[Category:Critical Care]]		[[Category:Pharmacology]] [[Category:Critical Care]]

	~~Ketamine: Drug information. UpToDate. www.uptodate.com. Accessed April 2, 2019.~~

Rossdonaldson1 at 21:57, 14 December 2022

2022-12-14T21:57:41Z

← Revisión anterior		Revisión del 21:57 14 dic 2022
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	===Procedural Sedation or Induction===		===Procedural Sedation or Induction===
	'''Options:'''		'''Options:'''
	*1-~~2mg~~/kg IV, followed by 0.5-~~1mg~~/kg IV PRN		*1-2 mg/kg IV, followed by 0.5-1 mg/kg IV PRN
	*4-~~5mg~~/kg IM → repeat 2-~~4mg~~/kg IM after 10 min if first dose unsuccessful		*4-5 mg/kg IM → repeat 2-4 mg/kg IM after 10 min if first dose unsuccessful

	===Subdissociative [[Analgesia]]===		===Subdissociative [[Analgesia]]===
	*0.1-0.~~3mg~~/kg IV PRN<ref>Morton NS. Ketamine for procedural sedation and analgesia in pediatric emergency medicine: a UK perspective. Paediatr Anaesth. 2008;18:25-29</ref><ref>Ahern TL, et al. The first 500: initial experience with widespread use of low-dose ketamine for acute pain management in the ED. Am J Emerg Med. 2015 Feb;33(2):197-201. PMID: 25488336. </ref>		*0.1-0.3 mg/kg IV PRN<ref>Morton NS. Ketamine for procedural sedation and analgesia in pediatric emergency medicine: a UK perspective. Paediatr Anaesth. 2008;18:25-29</ref><ref>Ahern TL, et al. The first 500: initial experience with widespread use of low-dose ketamine for acute pain management in the ED. Am J Emerg Med. 2015 Feb;33(2):197-201. PMID: 25488336. </ref>
	*Consider giving dose in 100 mL NS bag over 15 min to avoid negative sedation side effects<ref>Motov S, Mai M, Pushkar I, et al. A prospective randomized, double-dummy trial comparing IV push low dose ketamine to short infusion of low dose ketamine for treatment of pain in the ED. Am J Emerg Med. 2017;35(8):1095-1100</ref>		*Consider giving dose in 100 mL NS bag over 15 min to avoid negative sedation side effects<ref>Motov S, Mai M, Pushkar I, et al. A prospective randomized, double-dummy trial comparing IV push low dose ketamine to short infusion of low dose ketamine for treatment of pain in the ED. Am J Emerg Med. 2017;35(8):1095-1100</ref>

	===[[Combative patient]] and/or [[Excited delirium]]===		===[[Combative patient]] and/or [[Excited delirium]]===
	*4-~~6mg~~/kg IM or ~~1mg~~/kg IV<ref>Ketamine as Rescue Treatment for Difficulty-to-Sedate Severe Acute Behavioral Disturbance in the ED. Annals of EM. May 2016 67(5):581-587</ref>		*4-6 mg/kg IM or 1 mg/kg IV<ref>Ketamine as Rescue Treatment for Difficulty-to-Sedate Severe Acute Behavioral Disturbance in the ED. Annals of EM. May 2016 67(5):581-587</ref>

	===Ketamine Infusion<ref>Miller AC et al. Continuous intravenous infusion of ketamine for maintenance sedation. Minerva Anesth 2011;77:812-20.</ref>===		===Ketamine Infusion<ref>Miller AC et al. Continuous intravenous infusion of ketamine for maintenance sedation. Minerva Anesth 2011;77:812-20.</ref>===

Rossdonaldson1: /* Procedural Sedation or Induction */

2022-12-14T21:56:23Z

Procedural Sedation or Induction

← Revisión anterior		Revisión del 21:56 14 dic 2022
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	===Procedural Sedation or Induction===		===Procedural Sedation or Induction===
	*1.5-2 mg/kg IV '''OR'''		*1.5-2 mg/kg IV '''OR'''
	*4- ~~5mg~~/kg IM<ref>Green S. et al. What is the optimal dose of intramuscular ketamine for pediatric sedation?. Acad Emerg Med. 1999 Jan;6(1):21-6</ref> '''OR'''		*4-5 mg/kg IM<ref>Green S. et al. What is the optimal dose of intramuscular ketamine for pediatric sedation?. Acad Emerg Med. 1999 Jan;6(1):21-6</ref> '''OR'''
	*3-6 mg/kg IN<ref>Hall, D, et al. Intranasal ketamine for procedural sedation. Emerg Med J. 2014; 31:789-90.</ref> '''OR'''		*3-6 mg/kg IN<ref>Hall, D, et al. Intranasal ketamine for procedural sedation. Emerg Med J. 2014; 31:789-90.</ref> '''OR'''

Rossdonaldson1: /* Procedural Sedation or Induction */

2022-12-14T21:56:08Z

Procedural Sedation or Induction

← Revisión anterior		Revisión del 21:56 14 dic 2022
Línea 33:		Línea 33:
	==Pediatric Dosing==		==Pediatric Dosing==
	===Procedural Sedation or Induction===		===Procedural Sedation or Induction===
	*1.5-~~2mg~~/kg IV '''OR'''		*1.5-2 mg/kg IV '''OR'''
	*4-5mg/kg IM<ref>Green S. et al. What is the optimal dose of intramuscular ketamine for pediatric sedation?. Acad Emerg Med. 1999 Jan;6(1):21-6</ref> '''OR'''		*4- 5mg/kg IM<ref>Green S. et al. What is the optimal dose of intramuscular ketamine for pediatric sedation?. Acad Emerg Med. 1999 Jan;6(1):21-6</ref> '''OR'''
	*3-~~6mg~~/kg IN<ref>Hall, D, et al. Intranasal ketamine for procedural sedation. Emerg Med J. 2014; 31:789-90.</ref> '''OR'''		*3-6 mg/kg IN<ref>Hall, D, et al. Intranasal ketamine for procedural sedation. Emerg Med J. 2014; 31:789-90.</ref> '''OR'''

	==Special Populations==		==Special Populations==

Rossdonaldson1: /* Ketamine InfusionMiller AC et al. Continuous intravenous infusion of ketamine for maintenance sedation. Minerva Anesth 2011;77:812-20. */

2022-12-14T21:53:20Z

Ketamine InfusionMiller AC et al. Continuous intravenous infusion of ketamine for maintenance sedation. Minerva Anesth 2011;77:812-20.

← Revisión anterior		Revisión del 21:53 14 dic 2022
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	===Ketamine Infusion<ref>Miller AC et al. Continuous intravenous infusion of ketamine for maintenance sedation. Minerva Anesth 2011;77:812-20.</ref>===		===Ketamine Infusion<ref>Miller AC et al. Continuous intravenous infusion of ketamine for maintenance sedation. Minerva Anesth 2011;77:812-20.</ref>===
	*Post-intubation sedation start at 1-~~2mg~~/kg/hr		*Post-intubation sedation start at 1-2 mg/kg/hr
	**Titrate by 0.~~5mg~~/kg/hr q5 min		**Titrate by 0.5 mg/kg/hr q5 min
	**Max dose of 4-~~6mg~~/kg/hr		**Max dose of 4-6 mg/kg/hr
	*Field, austere drip<ref>BASIC KETAMINE INFUSION ANAESTHESIA. www.scancrit.com. May 31, 2012. http://www.scancrit.com/2012/05/31/ketamine-infusion-anaesthesia/.</ref>		*Field, austere drip<ref>BASIC KETAMINE INFUSION ANAESTHESIA. www.scancrit.com. May 31, 2012. http://www.scancrit.com/2012/05/31/ketamine-infusion-anaesthesia/.</ref>
	**Place ~~500mg~~ ketamine in 500 cc for 1mg/ml		**Place 500 mg ketamine in 500 cc for 1mg/ml
	**Standard maxi drip sets between 10-20 ggt/ml		**Standard maxi drip sets between 10-20 ggt/ml
	***Usually 20 gtt		***Usually 20 gtt
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	**For quick drip set with 20 ggt/ml		**For quick drip set with 20 ggt/ml
	***Use patient's weight in kg (70 kg for example)		***Use patient's weight in kg (70 kg for example)
	***Drip in the same number of drops per min (3.~~5mg~~/min = ~~210mg~~/hr = ~~3mg~~/kg/hr)		***Drip in the same number of drops per min (3.5 mg/min = 210 mg/hr = 3 mg/kg/hr)

	==Pediatric Dosing==		==Pediatric Dosing==

Elcatracho: /* Comments */

2020-11-29T23:48:50Z

Comments

← Revisión anterior		Revisión del 23:48 29 nov 2020
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	*IV preferred over IM (faster recovery, less emesis)		*IV preferred over IM (faster recovery, less emesis)
	*Nystagmus is seen as an effect of the medication		*Nystagmus is seen as an effect of the medication
			*Causes sympathetic drive leading to hypertension and tachycardia
			**Caution in those with HTN or at risk for CAD<ref>Green SM, Roback MG, Kennedy RM, Krauss B. Clinical practice guideline for emergency department ketamine dissociative sedation: 2011 update. Ann Emerg Med. 2011;57(5):449-461. doi:10.1016/j.annemergmed.2010.11.030 [PubMed 21256625]</ref>

	==See Also==		==See Also==