Ketamine With and Without Midazolam for Emergency Department Sedation in Adults: A Randomized Controlled Trial

Ketamine With and Without Midazolam for Emergency Department Sedation in Adults: A Randomized Controlled Trial

Background
Procedural sedation and analgesia is a technique of administering
sedatives (midazolam, propofol, etomidate) or dissociative agents
(ketamine) with or without opioid analgesics (fentanyl, morphine,
meperidine) to induce a state that allows the patient to tolerate
unpleasant procedures while maintaining cardiorespiratory function.
Ketamine, first described in 1965, has been administered extensively for procedural sedation and analgesia in children and is a safe and effective sedative analgesic for painful procedures not only in the emergency department (ED) but also in the out-of-hospital setting.
The widespread acceptance of ketamine as an agent for procedural
sedation and analgesia in adult ED patients may be limited by
physician apprehension about dreaming and hallucinations during
recovery, and unpleasant reactions and nightmares, collectively referred to as recovery agitation.