An adult receives ketamine sedation for reduction of a shoulder dislocation in the emergency department. Which combination best describes the expected physiological effects guiding monitoring during this dissociative sedation?

• A Respiratory depression with hypercarbia and hypotension
• B Apnoea requiring assisted ventilation in most patients
• C Bradycardia, bronchospasm, and reduced salivary secretions
• D Preserved airway reflexes with increased heart rate and blood pressure ✓

Explanation

Ketamine preserves airway reflexes and respiratory drive better than other agents while stimulating sympathetic outflow, producing increased heart rate and blood pressure, which supports its use for painful brief procedures. Respiratory depression and apnoea are uncommon at sedation doses, refuting options A and B. It increases salivation via Sjogren-like effects requiring antisialagogue cover, and causes bronchodilation, contradicting option C.

Reference: Morgan and Mikhail's Clinical Anesthesiology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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