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Propofol vs Ketamine — Adverse Effects

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

2010B Q07

Exam question

List the adverse properties of Propofol and Ketamine

CICMWrecks answer

Master answer

PROPOFOLKETAMINE
Resp–        Respiratory depression
–        Apnoea
–        Decreased RR, TV, MV, FRC		–        Mild respiratory stimulation
–        Respiratory depression if rapid IV administration
–        Increased secretions
–        Maintenance of pharygo-laryngeal reflexes
>  Laryngospasm
–        Bronchodilation
> Likely Ca channel mediated via R-ketamine isomer
CVS–        Peripheral vasodilation
–        Bradycardia
–        Hypotension		–        Indirect sympathomimetic effects → elevation of MAP
> Due to inhibition of noradrenaline reuptake
–        Direct cardiodepressant effects
CNS–        Sedation
–        Decreased cerebral blood flow		–        Increased cerebral blood flow
–        Increased cerebral O2 consumption
–        Sedation
–        Hallucinations
–        Emergence phenomena
GIT–        Nausea (although usually anti-emetic)–        Nausea
> Due to serotonin reuptake inhibition
Other–        Propofol infusion syndrome
> Rhabdomyolysis
> Metabolic acidosis
> Steatohepatitis
–        Injection site pain
–        Anaphylaxis
–        Leukocytosis		–        Anaphylaxis
–        Increased muscle tone

Past papers

Exam appearances

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2010B Q07 List the adverse properties of Propofol and Ketamine 30%