Question and Methods: Open-label prospective study comparing the efficacy and safety of ketamine versus haloperidol plus lorazepam in the treatment of acute combative agitation in the ED.
Findings: Significantly more patients treated with ketamine compared to haloperidol/lorazepam were sedated within 5 minutes (22% vs. 0%, p = 0.001).
Limitations: Potential bias secondary to open-label design, no allocation concealment, unblinded design, small sample size, and limited patient screening/enrollment based on physician practice patterns.
Interpretation: Ketamine remains a viable option for the rapid treatment of acute combative agitation in the ED, with haloperidol and lorazepam providing slower but equally adequate sedation.
By: Dr. Maeghan Fu