Ketamine - 7

Doses, Routes of Administration

Ketamine may be administered by the intravenous, intramuscular, oral, rectal, or nasal routes. (Ketamine has also been administered in the epidural and intrathecal spaces to achieve analgesia.)

General Anesthesia

  • Intravenous induction: 0.5 - 2 mg/kg -> peak effect in 30-60 seconds
  • Intramuscular induction: 4 - 10 mg/kg -> onset 5 minutes, peak 20 minutes
  • Maintenance: 0.5 - 1 mg/kg IV prn
    Or, better: 20 - 90 mcg/kg/min IV infusion
  • For TIVA may also be conveniently infused continuously IV in propofol:ketamine (4:1) mixture (e.g. propofol 200 mg + ketamine 50 mg)
  • may be wise to reduce dose in elderly patients

Sedation/analgesia

  • 0.2 - 0.8 mg/kg IV
  • 2 - 4 mg/kg IM
  • 5 - 10 mcg/kg/min IV infusion

Pediatric sedation-anesthesia:

ketamine mg/kg

Bioavailability *

Route % bioavailability
Nasal 50
Oral 20
IM 90
Rectal 25
Epidural 77



Greg Gordon MD
Updated: