ketamine
contraindicated in patients with underlying conditions in which increased blood pressure would pose a risk of complications such as aortic dissection, uncontrolled hypertension, myocardial infarction, or aneurysms.
It is contraindicated in those who have shown prior hypersensitivity to the drug.
It is not recommended for use during obstetrics, pregnancy, or breastfeeding, as it is unknown if this medication passes into breast milk.
Care must be used in patients who are intoxicated with ethanol due to additive sedation.
It is contraindicated in patients with schizophrenia due to the potential for exacerbating the underlying condition.
In patients with cerebrospinal fluid (CSF) elevations, the use of ketamine is controversial due to questionable elevations of intracranial pressure caused by ketamine. Some studies indicate that the concern for CSF elevation with ketamine has been overstated. Kropf et al. found similar hemodynamic properties compared with etomidate. Newer research suggests that ketamine may improve cerebral perfusion pressure and may, in fact, have neuroprotective properties.