KETAMIN (Ketaminum). 2 - (Metilamino) -2 - (2-chlorophenyl) - tsiklokegsanona hydrochloride.

     Synonyms : Kalipsol, Ketazhest, Ketalar, Velonarkon, Ketanest, Kalipsol, Ketaject, Ketalar, Ketamine, Ketanest, Ketolar, Vetalar, Ketaset, Velonarcon.

     White or almost white crystalline powder with low characteristic smell. The easily soluble in water and alcohol; PH aqueous 3.5-4.5.

     It is a tool that provides in intravenous and intramuscular a general anaesthetic (narkotiziruyuschee) and analgeziruyuschee effect.

     Features narkotiziruyuschego of ketamine-quick and short zffekt conservation in drug doses self adequate breathing.

     General anesthesia caused by ketamine, known as dissociative because of a drug relates mainly to the depressing impact on the area and associative podkovye education cheeks.

     Ketamine is metabolized in the body by demethylation. Most of the biotransformation products available within 2 h with urine, but few metabolites can remain in the body for several days. Cumulation with the introduction of multiple drugs can be identified.

     The minimum effective dose of ketamine with intravenously at 0.5 mg per 1 kg of body weight, with the consciousness shuts down in 1 - 2 minutes, and the effect lasted about 2 minutes, the dose of 1 mg / kg is about 6 minutes, a dose of 2 mg / kg for 10 - 15 minutes.

     With the introduction intramuscular effect is slower, but more long (dose 6 to 8 mg / kg effect develops through 6 to 8 minutes and lasts for 30-40 min).

     Analgesic effect of ketamine usually develops in giving vein within 10 minutes and lasts about 2 to 3 hours In intramuscular a more effective long. The drug reduces more somatic, pain sensitivity and less visceral pain sensitivity that should be considered in the abdominal operations.

     Ketamine is used for the combined mononarkoza and narcosis, especially in patients with low-AD, or the need to maintain self-breathing, or to get breathing mixture not containing nitrous oxide. It shows in emergency surgery and during the evacuation, particularly in patients with traumatic shock and krovopoterey (the rapid introduction of anaesthesia and the lack of depressed respiration and kardiostimuliruyuschim effect), with various surgical operations (including surgery), with combined intravenous anaesthesia and with the endoscopic procedure, heart catheterization, small surgical manipulation, dressings, including dental, ophthalmic and otorinolaringologicheskoy practice.

     There is evidence of the successful use of ketamine in obstetric practice with a cross-section deliveries.

     Enter ketamine intravenously (struyno instantly or fraktsionno and drip), or intramuscularly. Adults intravenously injecting a rate of 2 to 3 mg intramuscularly, 4 to 8 mg per 1 kg of body weight. To maintain narcosis injection of ketamine repeat (for 0,5-1 mg / kg intravenously or 3 mg / kg intramuscularly).

     The maintenance of general anesthesia continuous intravenous infusions of ketamine made it to 2 mg / kg per hour. This method is carried out through infuzomatov or through drip of 0.1% solution of ketamine in isotonic solution of glucose or sodium chloride (30-60 drops per minute).

     The children ketamine use for induction narcosis combined with various types of pain. Intramuscularly once imposed at the rate of 4 to 5 mg / kg of 5% solution (after sootvetstvuyushey sedation). For the narcosis impose 5% solution intramuscularly, or 1% solution intravenously struyno instantly, or 0.1% solution drip (at the speed of 30-60 drops per minute). Intramuscularly introduce newborns and infants at a rate of 8 to 12 mg / kg in children aged 1 to 6 years, 6-10 mg / kg, from 7 to 14 years, 4 to 8 mg / kg. Intravenous imposed at the rate of 2 -3 mg / kg. Maintenance of anesthesia are repeated injections of 3 to 5 mg / kg or intramuscularly 1 mg / kg intravenously struyno. Support anaesthesia can be obtained by intravenous drip 0.1% solution of ketamine (30-60 drops per minute).

     Ketamine can be used in combination with Neuroleptics (Droperidol, etc.) and analgesics (fentanyl, promedol, depidolor etc.) In these cases, reduce the dose of ketamine.

     When using ketamine should recognize its overall effect on the organism. The drug usually increases AD (20 - 30%) and an increase of heart to the increase of heart minute; Peripheral vascular resistance is reduced. Enlisting the heart could be reduced by diazepam (sibazona). Ketamine is usually not disturbed breathing, it is laringo - bronhiolospazma and not oppressing the reflexes of the upper respiratory tract : nausea and vomiting, as a rule, does not arise. With rapid intravenous possible respiratory depression. To reduce salivatsii imposed solution metatsina or atropine.

     The use of ketamine can be inadvertent movements gipertonusom, gallyutsinatornymi phenomena. These effects are removed or prevented the introduction of tranquilizers and droperidola.

     When intravenous solution ketamine is sometimes possible pain and redness on the skin during a vein, with the raising of psychomotor-initiation and the long disorientation.

     Ketamine is contraindicated patients with brain krovobrascheniya violations (including such violations in history), when expressed hypertension, eclampsia with severe circulatory decompensation, epilepsy and other diseases involving convulsant preparedness. Caution must be exercised when dealing in the larynx (to use muscle).

     Solutions should not be confused with ketamine barbiturates (rolls sludge).

     Product : 5% solution in ampoules (S o Ke t luti on a mini hydrochloridi 5% pro injectionibus) on 2 and 10 ml pack of 10 vials.

     Storage : List A. In the dark spot.

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