Ketamine Injectable: Anaesthesia Dosing and Precautions
Ketamine injectable guidance for induction and maintenance of general anaesthesia.
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Source reviewed
source date listed on the source page
Guide category
Injectable drugs
Safety boundary
Prescription medicine information for clinician-guided use.
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Therapeutic action
General anaesthetic.
Indications
Induction and maintenance of general anaesthesia.
Forms and strengths, route of administration
- 250 mg in 5 ml ampoule (50 mg/ml) for IM injection, IV injection, or infusion.
Dose
Child and adult
Induction:
- IV: 2 mg/kg injected slowly. Anaesthesia is produced within one minute and lasts 10 to 15 minutes.
- IM: 8 to 10 mg/kg. Anaesthesia is produced within 5 minutes and lasts 15 to 30 minutes.
- Maintenance: IV 0.5 to 1 mg/kg depending on recovery signs, approximately every 15 minutes.
- Maintenance: IM 5 mg/kg approximately every 20 to 30 minutes.
Duration
Depending on the duration of the operation.
Contra-indications, adverse effects, precautions
- Do not administer to patients with intraocular hypertension or pre-eclampsia.
- Administer with caution to patients with arterial or intracranial hypertension, coronary insufficiency, or psychiatric disorders.
- May cause hypertension, hypersalivation, hallucinations during recovery, and apnoea following rapid IV injection.
- Premedication to prevent hypersalivation and hallucinations: atropine IV 0.01 to 0.015 mg/kg plus diazepam slow IV 0.1 mg/kg during induction, or atropine IM 0.01 to 0.015 mg/kg plus diazepam IM 0.1 mg/kg 30 minutes before induction.
- Technical equipment for intubation and ventilation must be available and ready for use.
- Pregnancy: no contra-indication except in pre-eclampsia. For caesarean sections, do not exceed 1 mg/kg by IV injection.
- Breast-feeding: no contra-indication.
- Ketamine has no muscle relaxant properties.
- In some countries ketamine is on the list of narcotics: follow national regulations.
- Also comes in a 10 ml ampoule containing 500 mg (50 mg/ml).
Source
MSF Essential drugs practical guidelines (January 2026)
This page combines source-derived medicine reference sections with Kenza editorial context, while leaving out the Storage and Remarks sections from the source batch.
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