From the Guidelines
For a 75 kg patient, the recommended ketamine hydrochloride dosage is 0.75-2.0 mg/kg, which translates to 56.25-150 mg, given the standard dose range as reported in the study by 1. This dosage is based on the context of endoscopic sedation, where ketamine has been shown to be effective with minimal complications when used in combination with midazolam. Key considerations for ketamine administration include:
- Monitoring for vital signs, especially respiratory status, due to potential risks of hypoxemia, although rare as noted in the study by 1.
- Being aware of the potential for emergence reactions, which can be minimized with the use of midazolam in combination with ketamine, as suggested by 1.
- Recognizing the dose-dependent increase in heart rate, blood pressure, and cardiac output, which may necessitate caution in patients with ischemic heart disease, cerebrovascular disease, or hypertension, as mentioned in the study by 1. Given these considerations, the dosage of 0.75-2.0 mg/kg (56.25-150 mg for a 75 kg patient) is a reasonable guideline for ketamine use in clinical practice, particularly for procedural sedation, while ensuring patient safety and minimizing adverse effects.
From the FDA Drug Label
The initial dose of ketamine hydrochloride injection administered intravenously may range from 1 mg/kg to 4.5 mg/kg. The average amount required to produce 5 to 10 minutes of surgical anesthesia within 30 seconds following injection is 2 mg/kg.
For a 75 kg patient, the recommended ketamine dosage is:
- Intravenous Route: 1 mg/kg to 4.5 mg/kg, with an average dose of 2 mg/kg, which would be 75 mg to 337.5 mg, with an average dose of 150 mg.
- Intramuscular Route: 6.5 to 13 mg/kg, which would be 487.5 mg to 975 mg. 2
From the Research
Ketamine Dosage for a 75 kg Patient
The recommended ketamine dosage can vary depending on the specific use case and patient population.
- For a 75 kg patient, the dosage can be calculated based on the studies as follows:
- A dose of 0.5 mg/kg is commonly administered, which would be 37.5 mg for a 75 kg patient 3
- Some patients may respond to doses as low as 0.1 mg/kg, which would be 7.5 mg for a 75 kg patient, while others may require up to 0.75 mg/kg, which would be 56.25 mg for a 75 kg patient 3
- In pediatric procedural sedation, doses of 1.0 mg/kg or 1.5 mg/kg are often used, which would be 75 mg or 112.5 mg for a 75 kg patient, respectively 4, 5
- For rapid sequence intubation, doses of 1 to 2 mg/kg are typically used, which would be 75 mg to 150 mg for a 75 kg patient 6
- In cases of severe asthma exacerbation, a dose of 0.75 mg/kg has been used, which would be 56.25 mg for a 75 kg patient 7
Considerations for Ketamine Administration
- The route of administration can vary, including intravenous, intramuscular, subcutaneous, oral, sublingual, transmucosal, and intranasal 3
- The duration of treatment and frequency of administration can also vary depending on the specific use case and patient population 3
- It is essential to consider the potential for adverse events, such as hypotension, laryngospasm, and oxygen desaturation, particularly at higher doses 6