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Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Ketamine is a unique intravenous or intramuscular agent used for both analgesia and anaesthesia. It is a phencyclidine derivative. It takes a longer period than other intravenous anaesthetics before its non-hypnotic effects are maximal. Similarly, recovery is delayed. Effects include:

  • cardiovascular stimulation: arterial pressure can rise with tachycardia, making it good for battlefield analgesia in the presence of shock
  • muscle tone is increased
  • airway and laryngeal reflex tend to be maintained and less respiratory depression that other agents
  • low incidence of emergence phenomena, e.g. hallucinations and other psychotic behaviour - worse if patient is disturbed or over-stimulated during recovery; it is commonly given with a small dose of benzodiazepines to reduce the chance of this occurring.
  • antisialogue; less need for anti-secretory premedication.

It is contraindicated in those with hypertension, a history of stroke, or a significant psychiatric history, but it may be useful for uncooperative patients.

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