Ketamine is best for all but which scenario?

• A. Patients that need extra chemical control but not necessarily general anesthesia
• B. Patients who weigh <7 kg
• C. Patients who no longer need sedation
• D. Hospitals that do not want to carry tiletamine-zolazepam

Answer: (C)

Ketamine is used when you want analgesia and a dissociated state that allows handling or a short procedure without full general anesthesia, while still preserving spontaneous breathing and cardiovascular reflexes. It’s particularly useful when you need some chemical control but don’t require complete anesthesia, in very small patients where dosing is straightforward, or in settings where another drug like tiletamine-zolazepam isn’t available or desired.

In that context, the scenario where the patient no longer needs sedation is not a good fit for using ketamine. If there’s no sedation need, adding any sedative or anesthetic agent isn’t beneficial and only adds unnecessary drug exposure and potential side effects. So the best use of ketamine is for cases where sedation or analgesia is warranted, not when it’s no longer indicated.