The traditional dosing range of ketamine for analgesia is 0.1-0.6mg/kg IV.  It’s funny to use the word traditional because ketamine is still not completely universally considered an option for analgesia, despite its increasingly wider acceptance in the ED and growing amount of research literature supporting its use as an analgesic agent. It’s still technically off-label usage, so while EDs may have dosing charts for sedation use, many EDs do not have dosing algorithms or suggestions for analgesia.

Here’s a few ways to try it out next time.

Good: bolus 0.25mg/kg IV (10-20mg)

Better: 10-30 minute infusion (20mg over 10 min)

Best: 10 min loading dose, then continuous drip (20mg in 10 min, then 20mg/hour titrated)

 

Courtesy of Strayer (@emupdates) in SinaiEM lecture.

Sources

Ketamine for Analgesia in the ED

http://emupdates.com/2013/12/25/the-ketamine-brain-continuum/

JC: K is Good For You – Subdissociative Ketamine vs Morphine in the ED

May 2024
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