Ketamine

Patient w/ HTN, eclampsia or pre-eclampsia, severe coronary or myocardial disease, cerebrovascular accident or cerebral trauma.

Patient w/ cardiac decompensation, chronic alcoholic or acutely alcohol-intoxicated patients, pre-anaesth elevated CSF pressure, globe injuries, increased intraocular pressure (e.g. glaucoma), neurotic traits or psychiatric illness (e.g. schizophrenia, acute psychosis), acute intermittent porphyria, seizures, hyperthyroidism, pulmonary or upper resp infection, intracranial mass lesions, head injury, or hydrocephalus, hypovolaemia, dehydration, cardiac disease esp coronary artery disease (e.g. CHF, myocardial ischaemia, MI). Pregnancy and lactation. Patient Counselling Avoid driving, operating hazardous machinery or engaging in hazardous activities w/in 24 hr or more after anaesth. Monitoring Parameters Monitor heart rate, BP, resp rate, transcutaneous oxygen saturation, emergence reactions. Cardiac function should be continuously monitored in patients w/ increased BP or cardiac decompensation.

Emergence reactions (e.g. vivid dreams, hallucinations, confusion, irrational behaviour); increased muscle tone sometimes resembling seizures; temporary HTN and tachycardia, hypotension, bradycardia, arrhythmias, apnoea, laryngospasm, resp depression, diplopia, nystagmus, nausea, vomiting, lacrimation, hypersalivation, raised intraocular and CSF pressure, transient rash and pain at inj site, cystitis.

Prolonged recovery time w/ barbiturates or narcotics. May potentiate neuromuscular blocking effects of atracurium and tubocurarine including resp depression w/ apnoea. May increase risk of bradycardia, hypotension or decreased cardiac output w/ halogenated anaesth. May potentiate CNS depression and risk of resp depression w/ CNS depressants (e.g. phenothiazines, sedating H₁-blockers, skeletal muscle relaxants). May antagonise hypnotic effect of thiopental. May increase risk of HTN w/ thyroid hormones. May increase risk of hypotension w/ antihypertensive agents. Reduction in seizure threshold resulting in unpredictable extensor-type seizures when given concurrently w/ theophylline.

Anaesthetics- local & general

N01AX03 - ketamine ; Belongs to the class of other general anesthetics.