Introduction
Kain is a general anesthetic. It is used in major surgical procedures. It allows the procedures to be carried out without pain and distress. This injection is used in a hospital setting only.
Kain is used in general anesthesia. It causes loss of consciousness which is reversible. It is administered under the supervision of a healthcare professional.
The most common side effects include rash, nausea or vomiting. Inform your doctor if you are pregnant or are suffering from severe heart disease or had a stroke recently or suffered serious head or brain injury. It is safe to use in breastfeeding mothers.
Also, inform your doctor if you are on any medications or have any known allergy to this injection before the start of the procedure. Driving should not be done as Kain may cause sleepiness and may impair your ability to think or react. It is also advised not to operate machinery because of these effects.
Side effects of Kain
Common
- Rash
- Erythema (skin redness)
- Vomiting
- Nausea
- Agitation
- Nightmare
- Abnormal behavior
- Double vision
- Hallucination
- Increased respiratory rate
- High blood pressure
- Confusion
- Nystagmus (involuntary eye movement)
- Muscle coordination impaired
- Tonic-clonic seizures
- Tachycardia
How to use Kain
Your doctor or nurse will give you this medicine. Kindly do not self administer.
How Kain works
Kain is a general anaesthetic. It works by causing reversible loss of consciousness. This allows surgical procedures to be carried out without pain and distress.
Indication
Induction of anesthesia.
Administration
Reconstitution: 50 mg/mL and 100 mg/mL vials may be further diluted in 5% dextrose or 0.9% NaCl to prepare a maintenance infusion containing 1 mg/mL (or 2 mg/mL in patients w/ fluid restrictions).
Adult Dose
Intravenous
Induction of anaesthesia
Adult: 1-4.5 mg/kg via slow IV inj over 60 sec. A dose of 2 mg/kg produces surgical anaesthesia w/in 30 sec after inj lasting for 5-10 min.
Increments of half to the full induction dose may be repeated as needed for maintenance of anesth. Alternatively, a total induction dose of 0.5-2 mg/kg via infusion, given at an appropriate rate, and maintained at a rate of 10-45 mcg/kg/min, adjusted according to response.
Intramuscular
Induction of anaesthesia
Adult: 6.5-13 mg/kg. A dose of 10 mg/kg produces surgical anaesthesia w/in 3-4 min after inj lasting for 12-25 min.
Increments of half to the full induction dose may be repeated as needed for maintenance of anesth. For diagnostic or other procedures not involving intense pain: 4 mg/kg as initial dose.
Contraindication
Hypertension, history of cerebrovascular accident. Eye injury, raised ocular and intracranial pressure. Psychotic disorders.
Mode of Action
Ketamine is a noncompetitive N-methyl-D-aspartate receptor antagonist that blocks glutamate. It has a direct action on the cortex and limbic system. It produces a cataleptic-like state wherein the patient is withdrawn from the surrounding environment.
Precaution
Minimise verbal and tactile stimulation during recovery period. Chronic alcoholic and alcohol-intoxicated patients. Preanaesthetic elevated CSF pressure. Dependence and tolerance may develop. May impair ability to drive or operate machinery. Monitor cardiac function in patients with hypertension or cardiac decompensation. Pregnancy and lactation.
Side Effect
>10%
Emergence rxns (Emergence reactions e.g. vivid dreams, hallucinations, confusion, irrational behaviour)
HTN,Increased cardiac output,Increased ICP,Tachycardia,Tonic-clonic movements,Visual hallucinations,Vivid dreams
1-10%
Bradycardia,Diplopia,Hypotension,Increased IOP,Injection-site pain,Nystagmus
<1%
Anaphylaxis,Cardiac arrhythmia,Depressed cough reflex,Fasciculations,Hypersalivation,Increased IOP,Increased metabolic rate,Hypertonia,Laryngospasm,Respiratory depression or apnea with large doses or rapid infusions
Interaction
Prolonged recovery time w/ barbiturates or narcotics. May potentiate neuromuscular blocking effects of atracurium and tubocurarine including resp depression w/ apnoea. May increase risk of bradycardia, hypotension or decreased cardiac output w/ halogenated anaesth. May potentiate CNS depression and risk of resp depression w/ CNS depressants (e.g. phenothiazines, sedating H1-blockers, skeletal muscle relaxants). May antagonise hypnotic effect of thiopental. May increase risk of HTN w/ thyroid hormones. May increase risk of hypotension w/ antihypertensive agents. Reduction in seizure threshold resulting in unpredictable extensor-type seizures when given concurrently w/ theophylline.