From the Research
Ketamine is a pain medication that does not cause a huge drop in blood pressure when given intravenously, making it a suitable option for patients who require pain management without compromising hemodynamic stability. According to a study published in 2023 1, ketamine (20 mg) did not reduce tolerance to simulated hemorrhage in humans, unlike morphine, which reduced the cumulative stress index. This suggests that ketamine can be used in settings where blood pressure stability is crucial, such as in trauma or hypovolemic patients.
When administering ketamine, a dose of 0.1-0.3 mg/kg IV is recommended, as it tends to maintain or slightly increase blood pressure through sympathetic stimulation 2, 3. In contrast, other IV pain medications like morphine or hydromorphone may cause significant histamine release, leading to hypotension. Fentanyl is another option that has minimal histamine release, but ketamine's ability to maintain blood pressure makes it a preferable choice in certain situations.
It is essential to note that when administering any IV pain medication, slow administration, appropriate dosing based on patient factors (age, weight, comorbidities), and close monitoring are crucial to minimize hemodynamic effects 4, 5. Fluid boluses may be given concurrently if there is concern about potential hypotension. Overall, ketamine is a viable option for pain management in patients who require stable blood pressure, and its use should be considered in clinical practice.