Effect of Intramuscular Ketamine versus Haloperidol on Short-Term Control of Severe Agitated Patients in Emergency Department; A Randomized Clinical Trial
Objective: To evaluate the efficacy and safety of intramuscular ketamine and haloperidol in sedation of severely agitated patients in emergency department (ED).Methods: This randomized, double-blind clinical trial study was performed on agitated patients referring to two university educational hospi...
Main Authors: | , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Shiraz University of Medical Sciences
2018-10-01
|
Series: | Bulletin of Emergency and Trauma |
Subjects: | |
Online Access: | http://beat.sums.ac.ir/article_44451_2c789b78deed46e7b0fe53988dda9caa.pdf |
id |
doaj-9b5838de9877406c812790486b7994b3 |
---|---|
record_format |
Article |
spelling |
doaj-9b5838de9877406c812790486b7994b32020-11-24T21:58:26ZengShiraz University of Medical SciencesBulletin of Emergency and Trauma2322-25222322-39602018-10-016Issue 429229910.29252/beat-06040444451Effect of Intramuscular Ketamine versus Haloperidol on Short-Term Control of Severe Agitated Patients in Emergency Department; A Randomized Clinical TrialFarhad Heydari0Alireza Gholamian1Majid Zamani2Saeed Majidinejad3Emergency Medicine Research Center, Department of Emergency Medicine, Isfahan University of Medical Sciences, Isfahan, IranEmergency Department, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranEmergency Medicine Research Center, Department of Emergency Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranEmergency Medicine Research Center, Department of Emergency Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranObjective: To evaluate the efficacy and safety of intramuscular ketamine and haloperidol in sedation of severely agitated patients in emergency department (ED).Methods: This randomized, double-blind clinical trial study was performed on agitated patients referring to two university educational hospitals. Patients were randomly assigned to receive intramuscular (IM) haloperidol (5 mg) or IM ketamine (4 mg/kg). The primary outcome was time to adequate sedation (AMSS ≤ +1). Secondary outcomes included the need for additional sedatives, required intubation, duration of hospitalization, and side effects. Results: The 90 agitated patients were enrolled. The mean age was 30.37±7.36 years (range 18–56); 74% (67/90) were men. The mean time to adequate sedation in ketamine group (7.73 ± 4.71 minutes) was significantly lower than haloperidol group (11.42 ± 7.20 minutes) (p= 0.005). 15 minutes after intervention, the sedation score did not differ significantly in both groups (Ketamine:0.14 ± 0.59 vs. Haloperidol: 0.30 ± 0.60; p=0.167). The incidence of complications was not significantly different between groups. The physician's satisfaction from the patients’ aggression control was significantly higher in ketamine group.Conclusion: These data suggest ketamine may be used for short-term control of agitated patients, additional studies are needed to confirm if ketamine is safe in this patient population. Given rapid effective sedation and the higher physician satisfaction of ketamine in comparison to haloperidol, it may be considered as a safe and appropriate alternative to haloperidol.IRCT Code: IRCT20180129038549N5http://beat.sums.ac.ir/article_44451_2c789b78deed46e7b0fe53988dda9caa.pdfPsychomotor agitationEmergenciesHaloperidolKetamineAggitation |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Farhad Heydari Alireza Gholamian Majid Zamani Saeed Majidinejad |
spellingShingle |
Farhad Heydari Alireza Gholamian Majid Zamani Saeed Majidinejad Effect of Intramuscular Ketamine versus Haloperidol on Short-Term Control of Severe Agitated Patients in Emergency Department; A Randomized Clinical Trial Bulletin of Emergency and Trauma Psychomotor agitation Emergencies Haloperidol Ketamine Aggitation |
author_facet |
Farhad Heydari Alireza Gholamian Majid Zamani Saeed Majidinejad |
author_sort |
Farhad Heydari |
title |
Effect of Intramuscular Ketamine versus Haloperidol on Short-Term Control of Severe Agitated Patients in Emergency Department; A Randomized Clinical Trial |
title_short |
Effect of Intramuscular Ketamine versus Haloperidol on Short-Term Control of Severe Agitated Patients in Emergency Department; A Randomized Clinical Trial |
title_full |
Effect of Intramuscular Ketamine versus Haloperidol on Short-Term Control of Severe Agitated Patients in Emergency Department; A Randomized Clinical Trial |
title_fullStr |
Effect of Intramuscular Ketamine versus Haloperidol on Short-Term Control of Severe Agitated Patients in Emergency Department; A Randomized Clinical Trial |
title_full_unstemmed |
Effect of Intramuscular Ketamine versus Haloperidol on Short-Term Control of Severe Agitated Patients in Emergency Department; A Randomized Clinical Trial |
title_sort |
effect of intramuscular ketamine versus haloperidol on short-term control of severe agitated patients in emergency department; a randomized clinical trial |
publisher |
Shiraz University of Medical Sciences |
series |
Bulletin of Emergency and Trauma |
issn |
2322-2522 2322-3960 |
publishDate |
2018-10-01 |
description |
Objective: To evaluate the efficacy and safety of intramuscular ketamine and haloperidol in sedation of severely agitated patients in emergency department (ED).Methods: This randomized, double-blind clinical trial study was performed on agitated patients referring to two university educational hospitals. Patients were randomly assigned to receive intramuscular (IM) haloperidol (5 mg) or IM ketamine (4 mg/kg). The primary outcome was time to adequate sedation (AMSS ≤ +1). Secondary outcomes included the need for additional sedatives, required intubation, duration of hospitalization, and side effects. Results: The 90 agitated patients were enrolled. The mean age was 30.37±7.36 years (range 18–56); 74% (67/90) were men. The mean time to adequate sedation in ketamine group (7.73 ± 4.71 minutes) was significantly lower than haloperidol group (11.42 ± 7.20 minutes) (p= 0.005). 15 minutes after intervention, the sedation score did not differ significantly in both groups (Ketamine:0.14 ± 0.59 vs. Haloperidol: 0.30 ± 0.60; p=0.167). The incidence of complications was not significantly different between groups. The physician's satisfaction from the patients’ aggression control was significantly higher in ketamine group.Conclusion: These data suggest ketamine may be used for short-term control of agitated patients, additional studies are needed to confirm if ketamine is safe in this patient population. Given rapid effective sedation and the higher physician satisfaction of ketamine in comparison to haloperidol, it may be considered as a safe and appropriate alternative to haloperidol.IRCT Code: IRCT20180129038549N5 |
topic |
Psychomotor agitation Emergencies Haloperidol Ketamine Aggitation |
url |
http://beat.sums.ac.ir/article_44451_2c789b78deed46e7b0fe53988dda9caa.pdf |
work_keys_str_mv |
AT farhadheydari effectofintramuscularketamineversushaloperidolonshorttermcontrolofsevereagitatedpatientsinemergencydepartmentarandomizedclinicaltrial AT alirezagholamian effectofintramuscularketamineversushaloperidolonshorttermcontrolofsevereagitatedpatientsinemergencydepartmentarandomizedclinicaltrial AT majidzamani effectofintramuscularketamineversushaloperidolonshorttermcontrolofsevereagitatedpatientsinemergencydepartmentarandomizedclinicaltrial AT saeedmajidinejad effectofintramuscularketamineversushaloperidolonshorttermcontrolofsevereagitatedpatientsinemergencydepartmentarandomizedclinicaltrial |
_version_ |
1725852014460534784 |