Original paper here
What is this study about
- Authors hypothesized that given intramuscularly, Ketamine would work quicker (and safer) when compare to traditional benzodiazepine and antipsychotic medication.
- This is a RCT based on ED patients at a Canadian hospital in Vancouver
- Although ED diagnosis is not stated, the age of these patients and prior history suggest primary mental health disorder and drug/ alcohol plays a big role in their acute agitated state.
Bottom line
- Study is underpowered due to COVID-19 outbreak. In this RCT ketamine is about 3x faster to produce clinical effect compared to study drug. Lack of statistical evidence due to underpowered study, and lack of reporting of subsequent outcome (need for redosing, emergent phenomenon) limits the application of this study to day-to-day clinical practice.
- Choice of chemical sedation for acutely agitated patient in the ED, is still determined by individual clinician preference and familiarity.