Kowalski J Michael, Kopec Kathryn T, Lavelle Jane, Osterhoudt Kevin
From the *Division of Medical Toxicology, Einstein Medical Center Philadelphia, Philadelphia, PA; †Duke University Medical Center, Durham, NC; and ‡Division of Emergency Medicine and §The Poison Control Center, The Children's Hospital of Philadelphia, Philadelphia, PA.
Pediatr Emerg Care. 2017 Sep;33(9):e58-e62. doi: 10.1097/PEC.0000000000000578.
Control of the agitated patient in the emergency department is challenging. Many options exist for chemical sedation, but most have suboptimal pharmacodynamic action, and many have undesirable adverse effects. There are reports of ketamine administration for control of agitation prehospital and in traumatically injured patients. Ketamine is a noncompetitive N-methyl-D-aspartic acid receptor antagonist, making it an effective dissociative agent. We present 5 cases of ketamine administration to manage agitated adolescent patients with underlying psychiatric disease and/or drug intoxication. Ketamine, as a dissociative agent, may be an alternative pharmacological consideration for the control of agitation in patients with undifferentiated agitated delirium.
在急诊科控制躁动的患者具有挑战性。化学镇静有多种选择，但大多数药物的药效动力学作用欠佳，且许多药物有不良副作用。有关于院前及创伤性损伤患者使用氯胺酮控制躁动的报道。氯胺酮是一种非竞争性N-甲基-D-天冬氨酸受体拮抗剂，使其成为一种有效的分离麻醉剂。我们报告了5例使用氯胺酮治疗患有潜在精神疾病和/或药物中毒的躁动青少年患者的病例。氯胺酮作为一种分离麻醉剂，可能是控制未分化躁动谵妄患者躁动的一种替代药物选择。
