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The adverse effects of Ketamine on Procedural Sedation and Analgesia (PSA) in the Emergency Department

BACKGROUND: 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...

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Autores principales: Dilip, TS, Chandy, Gina Maryann, Hazra, Darpanarayan, Selvan, Jagadesha, Ganesan, Priya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8284211/
https://www.ncbi.nlm.nih.gov/pubmed/34322425
http://dx.doi.org/10.4103/jfmpc.jfmpc_2140_20
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author Dilip, TS
Chandy, Gina Maryann
Hazra, Darpanarayan
Selvan, Jagadesha
Ganesan, Priya
author_facet Dilip, TS
Chandy, Gina Maryann
Hazra, Darpanarayan
Selvan, Jagadesha
Ganesan, Priya
author_sort Dilip, TS
collection PubMed
description BACKGROUND: 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. MATERIALS AND METHODS: 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. RESULTS: 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. CONCLUSION: 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.
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spelling pubmed-82842112021-07-27 The adverse effects of Ketamine on Procedural Sedation and Analgesia (PSA) in the Emergency Department Dilip, TS Chandy, Gina Maryann Hazra, Darpanarayan Selvan, Jagadesha Ganesan, Priya J Family Med Prim Care Original Article BACKGROUND: 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. MATERIALS AND METHODS: 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. RESULTS: 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. CONCLUSION: 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. Wolters Kluwer - Medknow 2021-06 2021-07-02 /pmc/articles/PMC8284211/ /pubmed/34322425 http://dx.doi.org/10.4103/jfmpc.jfmpc_2140_20 Text en Copyright: © 2021 Journal of Family Medicine and Primary Care https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Dilip, TS
Chandy, Gina Maryann
Hazra, Darpanarayan
Selvan, Jagadesha
Ganesan, Priya
The adverse effects of Ketamine on Procedural Sedation and Analgesia (PSA) in the Emergency Department
title The adverse effects of Ketamine on Procedural Sedation and Analgesia (PSA) in the Emergency Department
title_full The adverse effects of Ketamine on Procedural Sedation and Analgesia (PSA) in the Emergency Department
title_fullStr The adverse effects of Ketamine on Procedural Sedation and Analgesia (PSA) in the Emergency Department
title_full_unstemmed The adverse effects of Ketamine on Procedural Sedation and Analgesia (PSA) in the Emergency Department
title_short The adverse effects of Ketamine on Procedural Sedation and Analgesia (PSA) in the Emergency Department
title_sort adverse effects of ketamine on procedural sedation and analgesia (psa) in the emergency department
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8284211/
https://www.ncbi.nlm.nih.gov/pubmed/34322425
http://dx.doi.org/10.4103/jfmpc.jfmpc_2140_20
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