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
IVIMSCPOIPSublingual (spray)
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.
Hamsters/Gerbils: Chemical restraint (with diazepam)
Guinea pig: Chemical restraint (Alone)
Guinea pig: Chemical restraint (with diazepam)
Guinea pig: Chemical restraint (with xylazine)
Rabbits: Chemical restraint (Alone)
Rabbits: Chemical restraint (with diazepam)
Rabbits: Chemical restraint (with xylazine)
Rabbits: Chemical restraint (Alone)
Rabbits: Induction (with diazepam)
Rabbits: Anesthesia without inhalants (with diazepam)
Rodents: Injectable anesthesia
Rabbits: Injectable anesthesia
Adjunct to anesthesia (geriatric/renal/liver dysfunction as premed prior to propofol/mask)
Slightly heavier sedation for radiographic procedures
Minor surgery, Penn hip or OFA-types of radiographic procedures requiring muscle relaxation
Surgical plane of anesthesia for OHE, castration, or abdominal surgery
Immobilizing extremely fractious dogs and wolf-hybrid dogs
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
Medium to small land Tortoises
Freshwater Turtles
Giant Land Tortoises (200 kg Aldabra tortoise)
Smaller Aldabra tortoises
Iguanas
Cardiovascular depression and arrhythmias (in animals with high sympathetic tone, shock, or severe CV disease)
Tachycardia (following high IV doses)
Marked respiratory depression (in some animals)
Skeletal muscle hypertonicity and spontaneous movement (if used alone)
Spacey, abnormal behaviour or dysphoria during recovery (1-2 hours)
Drug accumulation and prolonged recovery (with prolonged infusion)
> **Cardiovascular Caution**: Ketamine increases heart rate, blood pressure, and myocardial oxygen consumption. Avoid in patients where this is detrimental (e.g., unstable shock, congestive heart failure, hypertrophic cardiomyopathy).
> **Ocular Care**: Cats' eyes remain open after receiving ketamine. Protect from injury and apply an ophthalmic lubricant (e.g., Lacri-Lube) to prevent excessive corneal drying.
* **Hepatic/Renal Insufficiency**: Use with caution. In cats, ketamine is excreted almost exclusively via the kidneys; reduce doses or use cautiously in feline renal disease.
* **Sympathetic Tone**: Use with caution in animals with preexisting increased sympathetic tone (e.g., pheochromocytoma, hyperthyroidism).
* **Recovery**: Minimize exposure to handling or loud noises during the recovery period to reduce the incidence of emergence reactions (delirium, thrashing), but continue to monitor vital signs closely.
* **Hemorrhage**: Because ketamine can increase blood pressure, careful control of post-surgical hemorrhage (e.g., declawing) is required.
