Incidence and severity of recovery agitation after ketamine sedation in young adults

Purposes: Psychic recovery reactions after ketamine administration are not uncommon in adults, but yet are rare in children 15 years old and younger. The nature of such reactions has not been previously described in young adults, and accordingly we wished to quantify the incidence and severity of recovery agitation after ketamine sedation in patients aged 16 to 21 years. Basic Procedures: We prospectively collected data on 26 young adults aged 16 to 21 years who received ketamine for emergency department procedures, and treating physicians rated recovery "agitation," "crying," and "unpleasant hallucinations or nightmares" each on a 100-mm visual analog scale (0 mm = "none," 100 mm = "worst possible"). Main Findings: Treating physicians rated agitation and crying as entirely absent (rating 0 mm) in 25 of the 26 patients, and unpleasant hallucinations or nightmares as entirely absent (0 mm) in all 26. The single occurrences each of agitation (rating 46 mm) and crying (rating 23 mm) were not severe and resolved spontaneously without treatment. Principal Conclusions: In this small sample of young adults we observed no serious psychic recovery reactions, mirroring the low incidence of such responses well documented with children 15 years old and younger. This supports the expansion of ketamine use to young adults aged 16 to 21 years. © 2005 Elsevier Inc. All rights reserved.