Morgan Matthew W, Dore Ellen
Regions Hospital, Department of Emergency Medicine, St. Paul, Minnesota.
Clin Pract Cases Emerg Med. 2021 Nov;5(4):429-431. doi: 10.5811/cpcem.2021.6.53069.
Ketamine, a commonly used medication to treat agitation, has known adverse effects such as emergence reactions, vomiting, and laryngospasm. Opisthotonos has not been a commonly reported adverse reaction.
We report a case of opisthotonos brought on by administration of ketamine. A 24-year-old male with a history of schizophrenia was brought in by emergency medical services with opisthotonos shortly after treatment with 250 milligrams intramuscular ketamine by paramedics. He had become increasingly paranoid after being off his aripiprazole for a few weeks, and his family had become afraid for his and their safety. Paramedics administered ketamine to control his combative agitation, per protocol. The patient's extreme neck and back extension rapidly resolved with the administration of midazolam. Further history and workup did not reveal another cause for opisthotonos.
This is the first reported case to our knowledge of ketamine-associated opisthotonos in the emergency setting. Emergency care providers should be aware of this potential side effect.
氯胺酮是一种常用的治疗躁动的药物，已知其有诸如苏醒反应、呕吐和喉痉挛等不良反应。角弓反张并非常见的不良反应报告。
我们报告一例由氯胺酮给药引发角弓反张的病例。一名有精神分裂症病史的24岁男性，在护理人员给他肌内注射250毫克氯胺酮治疗后不久，被紧急医疗服务人员送来，出现角弓反张。他停用阿立哌唑几周后变得愈发偏执，其家人开始担心他以及自身的安全。护理人员按照规程给予氯胺酮以控制他的攻击性躁动。给予咪达唑仑后，患者颈部和背部的极度伸展迅速缓解。进一步询问病史和检查未发现角弓反张的其他病因。
据我们所知，这是在急诊环境中首例报告的与氯胺酮相关的角弓反张病例。急救护理人员应意识到这种潜在的副作用。
