Does not cause consistent increased ICP in sedated and ventilated patients.Causes direct smooth muscle relaxation and bronchodilation so ideal in status asthmaticus.Can cause increase in BP and HR through catecholamine release, useful in hypotensive/hypovolaemic patients.Dissociative anaesthetic with analgesic and amnestic properties.Additional IV doses 0.5-1mg/kg can be given to prolong sedation.IM dosing onset 3-8 minutes and duration 10-30 minutes.Ketamine 1.5-2mg/kg onset 30-60 seconds 5-15min duration.Apnoea seen in 1.5% (usually >1.5mg/kg dose).
Trismus and dystonic reactions are rare side effects.Avoid in trauma patients and any patient with hypovolaemia or hypotension.Painful on injection (can mix 2mL of 1% lignocaine into 20mL propofol to reduce pain).Etomidate 0.3-0.5mg/kg IV onset 20mmHg drop in SBP in 15%.Atropine 0.02mg/kg IV in response to bradycardia in children (not recommended routine).Fentanyl 3mcg/kg IV over 30-60 seconds may attenuate the reflex sympathetic response.If used, should give 3-5 minutes prior to RSI.Duration and finesse of laryngoscopy is the most important factor in physiologic perterbations seen with intubation.