Dilip T S, Chandy Gina Maryann, Hazra Darpanarayan, Selvan Jagadesha, Ganesan Priya
Department of Emergency Medicine, Christian Medical College, Vellore, Tamil Nadu, India.
J Family Med Prim Care. 2021 Jun;10(6):2279-2283. doi: 10.4103/jfmpc.jfmpc_2140_20. Epub 2021 Jul 2.
Procedural sedation and analgesia (PSA) in the emergency department (ED) is mainly used for wound irrigation, reduction of fractures, and wound closure. Ketamine is one of the most commonly used drugs for PSA in the ED. The study was conducted in the ED of a large tertiary care hospital in southern India to evaluate the adverse effects of Ketamine on PSA.
This is a prospective observational study performed in the ED for 6 months (October 2019-March 2020) in 151 patients who required Ketamine for PSA. Titrated doses of Ketamine was administered in all patients; hemodynamic variables and adverse events were recorded at timed intervals.
During the study period, a total of 151 patients in the ED required PSA. The mean age of the study Cohort was 37 ± 15 years, and males accounted for 83%. All individuals obtained adequate sedation and pain relief. It was found that the incidence of adverse reactions to Ketamine was higher in young people (18- to 40-year-old), which was 63%. The most common adverse reaction in the study population was 39 cases of hypertension (44.8%), followed by vomiting in 25 cases (28.7%) and delusion in 6 cases (4%). There was no significant adverse effect in any patients which necessitated admission.
Ketamine is a drug with good analgesic, sedative properties and has been shown to have a good safety profile with minimal adverse events for use as PSA in ED. Side effects were most common in the younger adult age group and hypertension was the most common side effect.
急诊科的程序性镇静镇痛（PSA）主要用于伤口冲洗、骨折复位和伤口缝合。氯胺酮是急诊科PSA最常用的药物之一。本研究在印度南部一家大型三级护理医院的急诊科进行，以评估氯胺酮对PSA的不良反应。
这是一项前瞻性观察性研究，于2019年10月至2020年3月在急诊科对151例需要氯胺酮进行PSA的患者进行了为期6个月的研究。所有患者均给予滴定剂量的氯胺酮；定期记录血流动力学变量和不良事件。
在研究期间，急诊科共有151例患者需要PSA。研究队列的平均年龄为37±15岁，男性占83%。所有患者均获得了充分的镇静和疼痛缓解。发现年轻人（18至40岁）对氯胺酮的不良反应发生率较高，为63%。研究人群中最常见的不良反应是高血压39例（44.8%），其次是呕吐25例（28.7%）和幻觉6例（4%）。没有任何患者出现需要住院的严重不良反应。
氯胺酮是一种具有良好镇痛、镇静特性的药物，已被证明作为急诊科PSA使用时具有良好的安全性，不良事件极少。副作用在年轻成人年龄组中最常见，高血压是最常见的副作用。
