Sedation, analgesia and paralysis
Ketamine (Ketalar) drip
Ketalar
Dosing
| Start | Analgesia 0.1–0.3 mg/kg/h (sub-dissociative); sedation 0.5–2 mg/kg/h |
|---|---|
| Titrate | By 0.05–0.1 mg/kg/h for analgesia, to effect for sedation |
| Maximum | Analgesia about 0.5 mg/kg/h; refractory status epilepticus may need more |
| Common bags | 250 mg in 250 mL (1 mg/mL); 500 mg in 100 mL (5 mg/mL) |
| Dose units | mg/kg/h |
Line and administration
- Peripheral or central
Watch for
- Emergence reactions (lower with concurrent sedation)
- Hypertension and tachycardia; hypersalivation
- Liver enzyme rise with prolonged infusion
Ketamine: full drug monographIndications, mechanism, pharmacokinetics, cautions and every dose the app lists.
In the one-pagers
- Airway and RSIRSI drugs: Ketamine: 1–2 mg/kg: About 30 s: Raises HR, BP; bronchodilates; emergence
- Behavioral Emergencies, Agitation and AbuseSedation by cause (NASEMSO doses, BETA choice): Immediate danger: Dissociative: Ketamine 4 mg/kg IM (3-5 min), 2 mg/kg IV; airway kit open
- Asthma and COPD ExacerbationsVentilating obstructed lungs: Ketamine is a useful induction drug in asthma (bronchodilates)
- Pulmonary EmbolismSupporting the failing RV: Intubation can trigger arrest: induction drops SVR, positive pressure cuts venous return, apnea raises CO₂ and PVR. If unavoidable: norepinephrine running, expert operator, preoxygenate, reduced-dose etomidate or ketamine, VT 6 mL/kg, plateau <30, low PEEP, ECMO team aware.
- BurnsWound care, pain and daily nursing checks: Burn pain is background, breakthrough and procedural, and dressing changes hurt most. Give opioids IV during resuscitation, since subcutaneous and IM absorption is unreliable, and expect doses to climb with tolerance. Add scheduled acetaminophen, ketamine for procedures, gabapentinoids for neuropathic pain and itch, and distraction such as virtual reality
- Common EMS MedicationsPain, sedation, nausea and bleeding: Ketamine, dissociative (NMDA): Pain; severe agitation: Pain 0.25 mg/kg (max 25 mg); agitation 4 mg/kg IM: Dangerous BP rise; laryngospasm, emergence
Practice Airway and RSI questions free196 exam-style questions with rationales on the topic where ketamine comes up most. No account or download needed.
Other sedation, analgesia and paralysis
- Propofol
- Dexmedetomidine
- Midazolam
- Fentanyl
- Cisatracurium
- Hydromorphone
- Rocuronium
- Vecuronium
- Pentobarbital
- Remifentanil
Practice free in your browser2,450+ exam-style questions with rationales. No account, no ads. Also free on the App Store and Google Play.
For education and exam preparation only. Follow your institution’s protocols. Study aid: check every dose against your local protocols and medical direction, the bag label and your pump.