Past Papers · SAQ

Anaesthetic Pharmacology — Propofol vs Ketamine

Current · V5 (2025) → H6.i Historical · V4 (2023) → K2.i, K4.i 1 exam appearance

2007B Q21

Exam question

Compare and contrast the cardiovascular effects of an induction dose of Propofol and ketamine.

CICMWrecks answer

Master answer

	PROPOFOL	KETAMINE
Dose for induction	2-2.5mg/kg 0.5-1mg/kg in critically unwell	0.5-1.5mg/kg
Autonomic nervous system	Reduction in sympathetic outflow	Increase in sympathetic outflow Centrally mediated
Heart rate	Blunts baroreceptor reflex → no reflex tachycardia Bradycardia due to reduced sympathetic tone	Increased due to increased sympathetic outflow
Contractility	Mild direct negative inotropy Secondary effect due to reduced sympathetic tone	Direct negative inotropy Increased sympathetic tone → increased overall inotropy (providing maximal sympathetic tone has not already been reached by the patient)
Peripheral vascular resistance	Direct vasodilation Secondary effect due to reduced sympathetic outflow	Direct vasodilation Overall, increased due to increased sympathetic tone
Blood pressure	Decreased	Usually increased
Cerebral circulation	Reduced CMRO2 Reduced cerebral blood flow	Increased CMRO2 Increased cerebral blood flow (No way are we diving in to the ICP question in this debate!)

Past papers

Exam appearances

1 appearance

Exam	Exact exam wording	Candidate success
2007B Q21	Compare and contrast the cardiovascular effects of an induction dose of Propofol and ketamine.	29%