Systematic review of parenteral ketamine for managing acute agitation in emergency settings.
Asian journal of psychiatry January 1, 2025 Christopher Peter, Satish Suhas, Guru S Gowda et al. 6 citations
Acute agitation occurs in 2.6% of emergency cases and up to 12.2% among patients with schizophrenia or bipolar disorder. Ketamine, given by injection, provides rapid sedation, with an average onset of 6.1 minutes. In a systematic review of 29 studies involving 1516 patients (mean age 35.5, 67.9% male), most received intramuscular ketamine at a mean dose of 3.83 mg/kg. However, 24.5% needed additional doses or rescue medications. Adverse effects included tachycardia (5.1%), hypertension (5.5%), hypersalivation (5.6%), and rare cardiac arrest (0.2%). Intubation occurred in 19.1%, but this could not be attributed solely to ketamine. No evidence showed worsening of psychotic symptoms.