What is the common IV dose range for ketamine when used for analgesia in the ED?

• A. 0.5–1 mg/kg IV
• B. 1–2 mg/kg IV
• C. 2–3 mg/kg IV
• D. 0.1–0.2 mg/kg IV

Answer: (A)

Ketamine used for analgesia in the ED is given at a low, subdissociative dose to relieve pain while keeping the airway and ventilation intact. The typical IV dose for analgesia is about 0.1 to 0.3 mg/kg, and many protocols allow up to 0.5 mg/kg in severe or refractory pain. Doses in the 0.5–1 mg/kg range sit closer to anesthesia induction, where the likelihood of dissociation, altered mental status, and other side effects increases. So the standard approach is to start at the lower end (and titrate) to achieve analgesia with the fewest adverse effects, reserving higher doses for specific situations where rapid, stronger pain control is required and appropriate monitoring is available.