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Dissociative Anaesthetic (NMDA Receptor Antagonist)

Ketamine (Anaesthesia/Sedation)

Brand names: Ketalar

Ketamine is a dissociative anaesthetic used for anaesthesia and procedural sedation, and at lower doses for analgesia; it is valued where airway reflexes and blood pressure need to be preserved (e.g. trauma, asthma).

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

See Full Prescribing Information for important dosage and administration instructions. ( 2 ) Induction of anesthesia: -- Intravenous route : Initially, 1 to 4.5 mg/kg administered slowly (over a period of 60 seconds). Alternatively, administer a dose of 1 to 2 mg/kg at a rate of 0.5 mg/kg/min. ( 2.2 ) -- Intramuscular route : Initially, 6.5 to 13 mg/kg. ( 2.2 ) Maintenance of anesthesia: Increments of one-half to the full induction dose may be repeated as needed ( 2.2 ). Adjust the dose according to the patient's anesthetic needs and whether an additional anesthetic agent is employed. ( 2.2 ) Supplement to other anesthetic agents : The regimen of a reduced dose of KETALAR supplemented with …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2026-03-27. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It is mainly an NMDA-receptor antagonist, producing dissociative anaesthesia with relative preservation of airway tone and respiration, bronchodilation and sympathetic stimulation.

Prescribing in practice

  • It tends to maintain or raise blood pressure and causes bronchodilation, useful in shock or severe asthma.
  • Emergence phenomena (vivid dreams, hallucinations, agitation) occur — a quiet recovery and a benzodiazepine can help; it increases secretions.
  • It is a controlled drug with recognised misuse potential.

Monitoring

Monitor conscious level, airway, oxygenation, heart rate and blood pressure; observe during emergence.

Counselling the patient

  • You may feel detached or have vivid dreams as it wears off.
  • Do not drive or make important decisions for the rest of the day.

Evidence & guidelines

Used for anaesthesia/procedural sedation and analgesia, particularly where haemodynamic stability or bronchodilation is wanted.

Reference: Miller's Anaesthesia; WHO Model List of Essential Medicines; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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