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| ARTICLES |
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| Year : 1977 | Volume
: 25
| Issue : 1 | Page : 45-47 |
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Ketamine hydrochloride (ketalar) intraocular pressure
GB Mathur, NC Desai, BB Shreevastava
Department of Ophthalmology, M.G. Hospital & Medical College, Jodhpur, India
Correspondence Address:
G B Mathur
Department of Ophthalmology, M.G. Hospital & Medical College, Jodhpur
India
 Source of Support: None, Conflict of Interest: None  | Check |
PMID: 612595 
How to cite this article:
Mathur G B, Desai N C, Shreevastava B B. Ketamine hydrochloride (ketalar) intraocular pressure. Indian J Ophthalmol 1977;25:45-7 |
Ketalar is a nonbarbiturate anesthetic chemically designated as dl. l-(o-Chlorophenyl)-2(methylamino) cycloexanone hydrochloride. It is formulated as a slightly acid (pH 3-5 to 5.5) solution for intravenous and intramuscular injection in concentration containing the equivalent of either 19 or 50 mg. Ketamine base per ml. and contains I : 10,000 phemeror as a preservative. The 10 mg. per ml. solution has been made isotonic with sodium chloride.
Ketalar is a rapid acting general anaesthetic producing anaesthetic state characterised by profound analgesia, normal (pharyangeal and laryngeal reflexes normal) or slightly enchanced muscle tone, cardiovascular and respiratory stimulation, and occasionally a transient and minimal respiratory depression.
The anesthetic state produced by Ketalar has been termed as "dissociation anaetthsia" in that it appears to selectively interrupt association pathways of the brain before producing somesthetic sensory blockade. It may selectively depress the thalamoneo-cortical system before siginificantly obstructing the more ancient cereberal centers and pathways.
Following administration of recommended doses of Ketalar, blood pressure and pulse rate are usually moderately and temporarily increased. Respiration is usually unaffected or mildly stimulated.
| Material and Methods | |  |
The study was conducted on 20 glaucomatus patients and 10 normal patients of either set at M. G. Hospital, and Medical College Jodhpur. Age varied between 20 to 50 years. No premedication was given except intramusular injection of atropine about 20 minutes before the use of Ketalar. Blood pressure. heart rate and respiration were recorded in all the patients 5 and 10 minutes after use of drug.
Basal reading of IOP was measured with Schiotz tonometer under local anaethesia. Then Ketamine hydrochloride (3 mg/kg.) was injected intravenously and I.O.P. recorded at 5 and 10 minutes interval.
| Observations | | |
In 10 normal persons no significant increase in I.O.P. was observed 5 and 10 minutes after ketalar injection. In 25 patients with Glaucama an increase of 13% of I.O.P. was observed 5 minutes after ketalar injection.
| Discussion | | |
Ketalar is recommended as a sole anaesthetic agent for diagnostic and surgical procedures and for all operations of short duration. With additional doses its period of anaesthesia can be prolonged for six hours safely. It has a large margin of safety and can be safely administratered repeatedly. [2]
Crossen and Hoy [1] and Dillong [3] reported slight and transient elevation in intracular pressure and recommended this drug for repeated tonometry in glaucomatous children. Yashikawa and Murai 9 observed 18% and 37% increase in I.O.P. at 5 and 15 minutes respectively and thereafter a gradual decrease to normal levels in 30 minutes. No definite correlation was however observed between rise in blood pressure and I.O.P. Kaul and Gode [4] reported no significant increase in I.O.P. in normal patients but in patients with pre-operative elevation of I.O.P. an increase of 64% was observed 2 minutes after Ketalar injections. In present study there was 13% increase in I.O.P. 5 minutes after injection of Ketalar in glaucomatous patients, whereas no significant rise in I.O.P. was observed in normal persons. No correlation was observed between rise in blood pressure and I.O.P. Our findings are similar to that of Yashikawa and Murai 9 .
The cause of elevation of pressure is un-known: It could be due to increase in the tone of extraocular muscles as is shown by patients receiving suxamethonium [6] .
Other mechanism is decrease in aqueous out flow [5] or stimulation of the occular centre in the midbrain, diencephalon and hypothalamous [8] .
Kaul and Gode [4] found of 64% rise in I.O.P. in glaucoma cases. We found that there is 13% rise of I.O.P. after Ketalar injunction in glaucomatous eyes whereas in normal eyes the rise of T.O.P. was not significant.
| References | | |
| 1. | Crossen. G. and Hoy. I. E., (1967), Jour. Paed, Ophthal, 4,20. 
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| 2. | Crossen. G. and Oget, D, 1971, Anaesth, Analg. Curr. Res. 50, 59.
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| 3. | Dillong, J. B., 1971, Proc. Roy Ser. Med., 64,1153.
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| 4. | Kaul and Gode 1974, East Arch. Ophthal. 2,247.
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| 5. | Kornbluth, W. Aladjemofe, Magora. F, 1959, Arch Ophthal, 61, 84.
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| 6. | Lincoff. H. A., Brenin. G.M. and Devoe, A.G. 1957,Amer. Jour. Ophthal, 43,440,
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| 7. | M. F.J. 1961, Arch. Ophthal, 65, 442.
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| 8. | Von Sallmanl, Macri, F. J. Wanko,T. 1956, Amer. Jour. Ophthal. 42, 130. |
[Table - 1], [Table - 2], [Table - 3]
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