Ketamine Administration: IV Route

Ketamine Administration: IV Route
The minimum dose at which the dissociative state can be
reliably achieved in children is 1.5 mg/kg IV, and common
loading doses are 1.5 to 2.0 mg/kg.4,71 Repeated incremental
doses of 0.5 to 1.0 mg/kg may be administered to prolong
sedation. Dissociative dosing in adults is typically 1.0 mg/kg,
with half doses repeated as needed.26,79
Although a distinct feature of ketamine is the preservation of
spontaneous respirations, the notable exception is when
ketamine is administered rapidly IV. Transient respiratory
depression and apnea have been reported 1 to 2 minutes after
rapid IV administration, presumably from unusually high
central nervous system levels.4,20,71 Accordingly, evidence is
suggestive that IV ketamine be administered during 30 to 60
seconds.4,12,13,16,71 Delayed respiratory depression past the
period of initial drug administration has not been reported,
except when attributable to coadministered agents.