Ketamine for rapid control of hyperactive delirium with severe agitation. A retrospective comparison study

JEM reports Pub Date : 2025-01-18 DOI:10.1016/j.jemrpt.2025.100138

Beatrice Borreani , Annalisa Belluti , Francescopaolo D'Adamo , Luca Acquarone , Cristina Cocino , Paolo Canepa , Francesco Quaglia , Martina D'Antoni , Andrea Alienda , Alessandro Riccardi

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Abstract

Background

The agitated patient represents a very large clinical problem for the work of the emergency department. The therapeutic goal is rapid symptom control while ensuring maximum patient safety. Hyperactive delirium constitutes a true clinical emergency, and some sedatives carry inherent risks. Ketamine has already demonstrated remarkable safety in this setting. OBJECTIVES This study aims to indentify an effective and safe option for the rapid control of severe psychomotor agitation METHODS Our retrospective study analyzes the comparison of ketamine alone, ketamine with droperidol, and midazolam with haloperidol. RESULTS During the period of January 2022 and September 2023 we identified 66 patients with severe psychomotor agitation (13–76 years), and we demonstrated a faster and more effective response in patients treated with ketamine, and a reduction in adverse events in patients treated with ketamine and droperidol. CONCLUSIONS Our data show that patients treated with ketamine exhibit a significantly faster response, with immediate patient control, with greater safety than patients treated with midazolam. The combination with droperidol increases clinical efficacy compared with ketamine alone.

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氯胺酮快速控制严重躁动的多动性谵妄。回顾性比较研究

焦虑患者是急诊科工作中一个非常大的临床问题。治疗目标是快速控制症状，同时最大限度地确保患者安全。过度活跃的谵妄构成了真正的临床紧急情况，一些镇静剂具有固有的风险。氯胺酮在这种情况下已经证明了显著的安全性。目的：寻找一种有效、安全的方法快速控制重度精神运动躁动。方法：回顾性分析氯胺酮单用、氯胺酮联用氟哌啶醇、咪达唑仑联用氟哌啶醇的比较。在2022年1月至2023年9月期间，我们确定了66例严重精神运动性躁动患者（13-76岁），我们证明氯胺酮治疗患者的反应更快，更有效，氯胺酮和氟哌啶醇治疗患者的不良事件减少。结论：我们的数据显示，与咪达唑仑治疗的患者相比，氯胺酮治疗的患者反应明显更快，患者立即得到控制，安全性更高。与单独氯胺酮相比，氟哌啶醇联用可提高临床疗效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JEM reports Emergency Medicine

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审稿时长

54 days