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For critically ill patients arriving at the emergency department, the drug ketamine can safely provide analgesia, sedation and amnesia for rapid, life-saving intubation, despite decades-old studies that suggested it raised intracranial pressure. The results of a systematic review of 10 recent studies of what many emergency physicians regard as a “wonder drug” are published online in Annals of Emergency Medicine.
"Apprehension for many years about ketamine’s effects on blood pressure or injured brains inhibited its use for intubation, especially in North America compared to Europe, but our review shows those concerns are likely overblown," said lead study author Corinne Hohl, MD, of the Department of Emergency Medicine at Vancouver General Hospital in Vancouver, Canada. "In view of recent concerns about the potential negative effects of an alternative induction agent, etomidate, ketamine should be considered routinely in patients with life-threatening infections and more regularly for patients who have been ‘found down,’ or unconscious, before being transported to the ER."
Lindsay Cohen, Valerie Athaide, Maeve E. Wickham, Mary M. Doyle-Waters, Nicholas G.W. Rose, Corinne M. Hohl. The Effect of Ketamine on Intracranial and Cerebral Perfusion Pressure and Health Outcomes: A Systematic Review. Annals of Emergency Medicine, 2014; DOI: 10.1016/j.annemergmed.2014.06.018