Was my nonverbal son given too much ketamine before anesthesia for his MRI scan?
#ketamine #anesthesia #MRI #son #dissociation #vomiting #nystagmus #sideeffects
**Background:**
– 21-year-old son
– 6ft tall, weighs approximately 240 lbs
– Nonverbal and uncooperative during IV insertion
**Experience:**
– Given 1000mg of ketamine for IV placement
– Took 3 hours to regain consciousness
– Experienced vomiting, suctioning, and remained dissociated for 6 hours
– Discharged from ER 8 hours later
– Nystagmus, loss of appetite, dry heaving continues
**Concern:**
– Was the dosage of ketamine too high for his weight and age?
Was this via injection into a muscle? Or how did they give him ketamine without an iv?
Was this all at once, or as two separate injections? The recommended dose is 4 to 6 mg per kilogram initially followed by another 2 to 3 milligrams per kilogram if the initial dose is not effective.
240 lb rounds to about 110 kg. 6 mg per kilogram plus 3 mg per kg * 110 kg is 990 mg, so that sounds about right.
Unfortunately, ketamine can have side effects, but it’s one of the best medications for inducing anesthesia without causing respiratory arrest.
If he is not cooperative for an IV that dose of ketamine IM looks about right. I am surprised he didn’t go to PACU instead of ER post procedure; ER doesn’t like to tie up their beds. I hope he is doing OK.
I’ve always used 10mg/kg IM for initial sedation and 1mg/kg IV for induction
Seems reasonable, probably IM.