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Ketamine 'safe' for use as a sedative, says research

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Research has found ketamine could be used as an alternative sedative during the intubation of critically ill patients.

The findings, published in The Lancet, show ketamine is a safe and valuable alternative to conventional etomidate used to help control breathing during treatment.

Professor Frederic Adnet of the Hopitaux de Paris and colleagues carried out a trial on 655 patients who needed emergency intubation. The patients were either given 0.3 mg/kg etomidate (328 patients) or 2mg/kg ketamine (327).

The team looked at the score of the sequential organ failure assessment (SOFA) - a scoring system for assessment of in-hospital morbidity - and dismissed any participants who died before reaching hospital or were discharged from intensive care within three days.

As a result 234 patients were analysed in the etomidate group and a further 235 in the ketamine group.

While the mean maximum SOFA score did not differ significantly between the two groups, 10.3 for etomidate, 9.6 for ketamine, adrenal insufficiency occurred in 86% of patients given etomidate. Just 48% of those given ketamine experienced the same side effect.

The authors concluded: ‘Our results show that ketamine is a safe and valuable alternative to etomidate for endotracheal intubation in critically ill patients, and should be considered in those with sepsis.’

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