Zaki Hany A, Shaban Eman, Bashir Khalid, Iftikhar Haris, Zahran Adel, Salem Emad El-Din M, Elmoheen Amr
Emergency Medicine, Hamad Medical Corporation, Doha, QAT.
Cardiology, Al Jufairi Diagnosis and Treatment, Doha, QAT.
Cureus. 2022 Jun 21;14(6):e26162. doi: 10.7759/cureus.26162. eCollection 2022 Jun.
We aim to discuss the efficacy and adverse effects of using ketamine in agitated patients in the emergency department (ED) compared with the combination therapy of haloperidol with benzodiazepine. This systematic review followed Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) guidelines. An electronic search from PubMed/Medline, Cochrane library, and Google Scholar was conducted from their inception to 30 April 2022. We included agitated patients in ED who were given infusion with ketamine only. Our comparative group was patients infused with combined therapy of haloperidol and benzodiazepine. We did not include letters, case reports, abstracts, conference papers, appraisals, reviews, and studies where full text was unavailable. We did not put any language restrictions. Three studies were selected in our manuscript (one cohort and two randomized controlled trials). All three studies showed that ketamine was used to achieve sedation in less time than the other group. However, two studies reported significantly more adverse effects in ketamine-infused groups. We concluded that ketamine use is superior when its primary focus is to sedate the patient as quickly as possible, but it carries some side effects that should be considered. However, we still need more studies assessing the efficacy of ketamine in agitated patients presenting in the ED.
我们旨在探讨与氟哌啶醇联合苯二氮䓬类药物的联合疗法相比，在急诊科（ED）使用氯胺酮治疗躁动患者的疗效和不良反应。本系统评价遵循系统评价和Meta分析的首选报告项目（PRISMA）指南。从PubMed/Medline、Cochrane图书馆和谷歌学术搜索库建立之初到2022年4月30日进行了电子检索。我们纳入了仅接受氯胺酮输注的急诊科躁动患者。我们的对照组是接受氟哌啶醇和苯二氮䓬类药物联合治疗的患者。我们未纳入信函、病例报告、摘要、会议论文、评估、综述以及无法获取全文的研究。我们没有设置任何语言限制。我们的手稿中选择了三项研究（一项队列研究和两项随机对照试验）。所有三项研究均表明，使用氯胺酮比另一组更快地实现镇静。然而，两项研究报告氯胺酮输注组的不良反应明显更多。我们得出结论，当主要目标是尽快使患者镇静时，使用氯胺酮更具优势，但它会带来一些应予以考虑的副作用。然而，我们仍需要更多研究来评估氯胺酮对急诊科躁动患者的疗效。
