Ketamine or atracurium

You should differentiate between pain control, sedation, and neuromuscular blocking.

when and how to use one of them will depend on many factors such as the patient condition and the nature of the medication.

You have to ensure adequate pain control and sedation prior to and during administration of neuromuscular blockade.

Meaning, you can’t use Atracurium (neuromuscular blocking agent) alone.

So, it’s okay, if not a necessity, to use both Ketamine for sedation and analgesia, and Atracurium to induce ICU paralysis (eg, facilitate mechanical ventilation).