 Blood pressure and heart rate will be monitored hourly for four hours before, during, and after the end of the procedure. Hypotension will be defined as a systolic blood pressure 90 mmHg or a decrease of systolic blood pressure of 40 mmHg, hypertension will be defined as a systolic blood pressure 180 mmHg or an increase of systolic blood pressure of 40 mmHg, and tachycardia is defined as a heart rate 120 beatsminute or an increase of 20 beatsminutes. The administration of fluid boluses or vasopressor therapy will also be recorded. It is anticipated that these therapies will not be required. The Richmond Agitation Sedation Scale RASS score will be used to determine neurologic disassociation RASS score of 2 to 4 indicating agitation or combative and over-sedation RASS score of -3 to -5 indicating moderate to deep sedation. The RASS score is performed as routine care every hour and it will be recorded for four hours before and after the end of the procedure. Open label ketamine may be administered by the burn ICU physician if patients have received both doses of study drug and subjects report pain scores of 7 out of 10 despite the administration of 400 mcg fentanyl equivalents this represents the 75th percentile of fentanyl required in the medication usage evaluations conducted at UCH or a RASS score of -4 to -5, indicating levels of sedation deep enough to warrant caution against administering additional doses of opioids or anxiolytics. The use of open label ketamine will be recorded and comparatively assessed. 