I spent a little more time looking at this after I posted and came up with the following which works for me:
^ key [a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9][a-f0-9]$
Unfortunately NCM doesn't appear to support the repeatables so the simpler ^\s{3}key\s[a-f0-9]{48}$ doesn't work, but this makes it very specific of the beginning line spacing and 48 hex characters on a line so should still allow key changes on Cisco for example as they are typically shorter than 48 characters and many times have an encryption level (0, 5, or 7) noted.