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KETAMINE ANAESTHESIA
Ketamine as the sole method of anaesthesia is widely used without
any safeguards of the airway. However, it cannot be recommended
as a completely safe method in the presence of a full stomach
due to the risk of regurgitation and aspiration.
Ketamine anaesthesia is suitable:
| :: |
When
muscle relaxation is not required, especially in children |
| :: |
As
a “fall-back” technique if your inhalational
apparatus, or gas supply for a Boyle’s machine,
fails |
| :: |
If
you have to give general anaesthesia without inhalational
apparatus, for example at an accident to release a trapped
casualty. |
Unsupplemented
ketamine
| 1 |
Give
a sedative drug and atropine as premedication. |
| 2 |
Insert
an indwelling intravenous needle or cannula. In a struggling
child, it is more convenient to delay this until after
ketamine has been given
intramuscularly. |
| 3 |
Give
ketamine 6–8 mg/kg of body weight intramuscularly
or 1–2 mg/kg
intravenously (mixed with an appropriate dose of atropine, if not already given
in premedication). |
| 4 |
After
intravenous injection of ketamine, the patient will
be ready for surgery in 2–3 minutes, and after
intramuscular injection in 3–5 minutes. |
| 5 |
Give
supplementary doses of ketamine if the patient responds
to painful stimuli. Use half the original intravenous
dose or a quarter of the original intramuscular dose. |
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