Ketamine is best for all but: which scenario is not ideal?

• 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)

The main idea here is when ketamine is most appropriate as a sedation/analgesia option. Ketamine provides meaningful chemical control, analgesia, and dissociative anesthesia without requiring full general anesthesia, and it can be handy in very small patients or in settings that want to avoid tiletamine-zolazepam.

Using ketamine in cases where the patient no longer needs sedation is not ideal because there’s no indication for pharmacologic calming or analgesia, and adding ketamine unnecessarily exposes the patient to drug effects and recovery time. In other words, if the procedure or condition no longer requires sedation, you should wean off or avoid sedatives rather than continue with ketamine. The other scenarios align with ketamine’s strengths: needing extra chemical control without full GA, safely dosing in small patients, and providing an alternative in places that don’t want tiletamine-zolazepam.