Included in the formulation
Included in the list (Order of the Government of the Russian Federation No. 2782-r of 30.12.2014):VED
Pharmacodynamics:Oppresses the subcortical formations of the thalamus and the associative zone, providing a dissociative anesthetic effect. It has a pronounced analgesic effect, but insufficient miorelaxing action: cough, laryngeal and pharyngeal reflexes are preserved, independent pulmonary ventilation is carried out.
Pharmacokinetics:After intravenous administration, it is quickly distributed in organs that are well supplied with blood, including the brain, and then redistributed in tissues with a lowered perfusion. Penetrates through the blood-brain and placental barrier.
The narcotic effect develops 30-60 seconds after intravenous administration and lasts for 15-40 minutes. The analgesic effect lasts for 2 hours. Metabolism in the liver.
Half-life is 2-3 hours. Elimination by the kidneys in the form of metabolites.
Indications:It is used for introductory or basic anesthesia in case of short-term surgical interventions, painful diagnostic or instrumental manipulations. Used for transportation of patients, for treatment of burn surfaces.
XVIII.R50-R69.R52.9 Pain, unspecified
XIX.T20-T32.T30 Thermal and chemical burns, unspecified
XXI.Z100.Z100 * CLASS XXII Surgical Practice
Contraindications:Violations of cerebral circulation, stenocardia, arterial hypertension, chronic renal failure, eclampsia, epilepsy in children, individual intolerance.
Carefully:Kidney diseases, operations on the larynx and pharynx, hypersensitivity.
Pregnancy and lactation:Recommendations for FDA - Category C. It is used with caution during pregnancy and lactation in cases where the intended benefit exceeds the risk to the fetus and newborn.
Dosing and Administration:Use in children
Intravenous bolus: 0.5-4.5 mg / kg; intramuscularly: 2-5 mg / kg.
Adults
Intravenously bolus, at a dose of 1-4 mg / kg. The initial dose is administered within one minute, with repeated administration, 1 / 2-1 / 3 of the initial dose is applied or a 0.1% solution is administered dropwise on glucose or physiological saline at a rate of 20-60 drops per minute.
Intramuscularly: 6,5-13 mg / kg.
Total administered dose: for intravenous administration - 2-6 mg / kg per hour; 13 mg / kg - with intramuscular injection.
Side effects:Central and peripheral nervous system: psychomotor agitation, hallucinations upon withdrawal from anesthesia.
Respiratory system: shortness of breath, respiratory depression.
The cardiovascular system: arterial hypertension, tachycardia.
Digestive system: hypersalivation.
Allergic reactions.
Overdose:Inhibition of breathing.
Treatment is symptomatic: conducting artificial ventilation is preferable to the use of analeptics.
Interaction:Strengthens the effect of inhalation for anesthesia.
Strengthens the effect of muscle relaxants: suksametonium iodide and tubocurarine chloride, does not affect the effect of pancuronium bromide.
Benzodiazepines and droperidol reduce the risk of developing a psychomotor reaction, tachycardia and hypertension.
Incompatible with barbiturates (not recommended to mix in a single solution) - ketamine inactivated, precipitating.
Special instructions:After the application of ketamine to patients within 24 hours, it is not recommended to drive vehicles and work with moving mechanisms.