Ketamine

用途

• Anesthesia
• Anesthesia
• Anesthesia
• Camelids (llamas and alpacas) - Anesthetic
• Camelids - Procedural pain (e.g., castrations) when recumbency is desired
• Restraint
• Diagnostic or minor surgical procedures not requiring skeletal muscle relaxation
• Immobilizing agent (requiring more sedation)
• Highly aggressive cats
• NMDA antagonist for adjunctive pain control (mild to moderate pain)
• Intraoperative use (if anesthesia induced with drug other than ketamine)
• In combination with opioids or lidocaine
• MLK (morphine/lidocaine/ketamine) mixture

給藥方式

可能的副作用

• Hypertension
• Hypersalivation
• Respiratory depression (at high doses or rapid IV administration)
• Hyperthermia (especially in cats)
• Emesis
• Vocalization
• Erratic and prolonged recovery (emergence delirium)
• Dyspnea
• Spastic jerking movements and muscular tremors
• Seizures (up to 20% of cats at therapeutic doses)
• Hypertonicity and opisthotonos
• Cardiac arrest
• Pain after IM injection
• Eyes remain open (risk of corneal drying/ulceration)

注意事項與禁忌

• Prior hypersensitivity reactions to ketamine
• Animals intended for human consumption
• Use as a sole agent for major surgery (due to poor muscle relaxation and visceral analgesia)
• Increased cerebrospinal fluid (CSF) pressure or head trauma
• Significant hypertension, heart failure, or arterial aneurysms
• Hypertrophic cardiomyopathy (HCM) in cats
• Increased intra-ocular pressure or open globe injuries (relative)
• Procedures involving the pharynx, larynx, or trachea (relative)
• Preexisting seizure disorders (use with extreme caution)
• Animals whose eyes are at risk of perforation
• Raised intraocular pressure (IOP)
• Raised intracranial pressure (ICP)

藥物相互作用

• Chloramphenicol (parenteral): May prolong the anesthetic actions of ketamine
• CNS Depressants (Narcotics, barbiturates, diazepam): May prolong the recovery time after ketamine anesthesia
• Halothane: Recovery rates may be prolonged and the cardiac stimulatory effects of ketamine may be inhibited; close monitoring of cardiac status is recommended
• Ivermectin: Recommended not to use ivermectin in reptiles within 10 days of ketamine
• Neuromuscular blockers (e.g., succinylcholine, tubocurarine): May cause enhanced or prolonged respiratory depression
• Thyroid hormones: May induce severe hypertension and tachycardia; beta-blockers may be of benefit in treating these effects
• Alpha-2 adrenergic agonists (e.g., medetomidine, dexmedetomidine): Synergistic anaesthesia and prevention of muscle hypertonicity. Reversal of the alpha-2 agonist must be delayed until 45 minutes after ketamine administration to prevent unopposed ketamine excitation.
• Benzodiazepines: Synergistic anaesthesia and prevention of ketamine-induced skeletal muscle hypertonicity.

常見問題