Ketamine

Analgesia

Analgesia · NMDA antagonist

Ketamine

Dose

RSI 1–2 mg/kg IV; sedation 0.5–1 mg/kg; analgesia 0.1–0.3 mg/kg over 10 min then 0.1–0.3 mg/kg/h

Mechanism

Dissociative anaesthesia; bronchodilation, sympathomimetic

Indications

  • RSI in shock / asthma
  • Procedural sedation
  • Analgesia (sub-dissociative)
  • Treatment-resistant depression (specialist)

Contraindications

  • Severe uncontrolled hypertension
  • Severe coronary disease (relative)

Use

Maintains airway reflexes and BP — ideal for shocked patients.

Monitoring

BP, HR, sedation depth, emergence phenomena.

Side effects

  • Emergence delirium (mitigate with midazolam)
  • Hypertension, tachycardia
  • Hypersalivation
  • Laryngospasm (rare)

Related in WardRound

Always confirm dose against your local formulary / BNF before prescribing.

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