Masteron side effects causes analgesic effect of incomplete suppression of consciousness and preservation of spontaneous breathing, pharyngeal, laryngeal and cough reflexes It is a specific set of symptoms: somatic analgesia, a condition resembling neuroleptic analgesia, increases blood pressure, myocardial contractility, minute volume of blood and myocardial oxygen demand, relaxes the smooth muscles of the bronchi. Almost does not reduce the tone of the skeletal muscles, can cause involuntary muscle twitching.
Introduction and basic general anesthesia (especially in patients with low blood pressure or the need to maintain spontaneous breathing, or during mechanical ventilation breathing mixtures not containing dinitrogen monoxide (nitrous oxide).
Emergency surgery (including stages evacuation, particularly in patients with traumatic shock and blood loss).
Various surgical operations for multicomponent intravenous anesthesia.
The painful diagnostic procedures (endoscopy, cardiac catheterization), minor surgical procedures for burns, dressings, etc. procedures.
Hypersensitivity to the drug, hypertension (et al. State in which high blood pressure is contraindicated), angina pectoris or myocardial infarction (including in the last 6 months), severe renal failure, cerebrovascular accident (incl . history), pre-eclampsia, eclampsia, epilepsy and other convulsive conditions, alcoholism, pregnancy and lactation.
Contraindications to ketamine anesthesia in children are any diseases accompanied by seizure activity.
Be wary – decompensated chronic heart failure, surgery on the larynx and pharynx.
Dosing and Administration
Ketamine administered intravenously (simultaneously or fractional jet and drip), or intramuscularly. Adults drug is administered intravenously, the rate of 2-3 mg / kg intramuscularly -4-8 mg / kg body weight.To maintain anesthesia drug is administered at 0.5-1 mg / kg intravenously or 3 mg / kg intravenously or intramuscularly, at 2 mg / kg / hr (using or by infuzomatora drip a solution of 0.1% ketamine (5 % solution of dextrose (glucose) and 0.9% at a rate of 20-50 drops / min chloride) of sodium chloride. in children the drug is used for induction of anesthesia in different types of combined analgesic (administered intramuscularly once a rate of 4.5 mg / kg as a . 5% solution after appropriate premedication) For primary anesthetic ketamine is administered intramuscularly (5% solution) or intravenously (bolus 1% masteron side effects solution in one stage or 0.1% solution dropwise at 50-60 drops / min) with intramuscular dose depends on body weight and age of the children:. newborns and infants – 8-12 mg / kg, for children from 1 year to 6 years – 6-10 mg / kg, 7-14 years – 4-8 mg / kg intravenously administered at a dose of 2 -3 mg / kg. Maintaining provide anesthesia repeated injections of ketamine (3-5 mg / kg intramuscularly or 0.5-1 mg / kg intravenously or drip of a 0.1% solution of the drug at a rate of 30-60 drops / min) . to enhance the action of ketamine it is usually used in combination with antipsychotic drugs (droperidol) and analgesics (fentanyl, promedol et al.) to be reduced while the dose of ketamine.
Side effect On the part of the nervous system: depression of the respiratory center, muscle rigidity, involuntary muscle activity (for prevention must first enter diazepam); in the output period of general anesthesia – psychomotor agitation, hallucinations, prolonged disorientation, psychosis. The respiratory system: dyspnea, obstruction of the upper airways due to spasm of the masticatory muscles and sticking of language, increased bronchial secretion and salivation. Cardio-vascular system : increase in blood pressure, tachycardia. digestive system: hypersalivation, nausea. Local reactions: pain and redness along the vein at the injection site.
When administered in high doses of ketamine intravenously (3 mg / kg) in some cases may experience respiratory depression. In these cases shows the artificial lung ventilation. When hallucinations advisable to use antipsychotics (haloperidol), and seizures – diazepam. If necessary spend symptomatic therapy.
Interaction with other drugs
Ketamine increases the effects of drugs for general anesthesia, narcotic analgesics, antipsychotics (neuroleptics), anxiolytics (tranquilizers) and other drugs which depress the central nervous system.
Before using ketamine should be abolished lincomycin, lithium preparations (for 1- 2 days), monoamine oxidase inhibitors (for 15 days). You can not mix in the same syringe with barbiturates (pharmaceutically incompatible – the formation of a precipitate).
Droperidol and benzodiazepines, including sibazon weaken risk manifestations psychomimetic and motor activity, as well as the occurrence of tachycardia and hypertension.
Do not appoint a sympathomimetic and drugs have a stimulating effect on the cardiovascular system (increased hypertensive and arrhythmogenic action, increased myocardial oxygen demand).
kardiostimuliruyuschy effect of ketamine is weakened when combined with antipsychotics, anxiolytics.
ketamine increases the muscle relaxant effect of tubocurarine and ditilina does not change – pancuronium and suxamethonium.
during general anesthesia in patients taking iodine-containing preparations, and thyroid hormones, it is likely to increase blood pressure and tachycardia (eliminated beta-blockers).
Ketamine is used only in a hospital or emergency room.
In order to prevent increased secretion of mucous membranes and salivary glands of the funds should be included sedation, atropine or metotsiniya iodide and slowly introduce the basic dose (not to exceed 3 mg / kg). While ketamine anesthesia to conduct inhalation of oxygen mix with air in a ratio of 1:. 2
When using ketamine should monitor the function of breathing, especially for upper airway (possible spasm of the masticatory muscles and the tongue).
Care should be taken during operations masteron side effects on the larynx and the pharynx (used muscle relaxants).
to prevent muscle stiffness and involuntary twitches during premedication by intramuscular or intravenous diazepam.
in order to prevent the development of psychomimetic actions of the funds should be included droperidol premedication, diazepam.
The solution for intravenous and intramuscular injection of 50 mg / ml. 2 ml and 5 ml ampoules or 5 ml vials. On 5 ampoules or vials in blisters.
At 1, 2 blisters (5 vials each) with instructions for use in a stack of cardboard; 20, 50 or 100 contour cell packages respectively with 10, 25 and 50 instructions for use in a box made ??of cardboard or a box made ??of cardboard (to the hospital).
In one contour cellular packaging (5 bottles) and instructions for use in a stack of cardboard; 30-50 contour of cellular packages (5 vials each) with instructions for use (number of packages) in a box of paperboard or cardboard box (for hospital).
In the dark and inaccessible to children. List II «the List of narcotic drugs, psychotropic substances and their precursors subject to control in the Russian Federation.”
2 years. Do not use beyond the expiration date specified in category packaging.
Conditions of supply of pharmacies
apply in a hospital.