Document Type : Original Article
Authors
1 Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran
2 Student research center, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran
3 Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran.
Abstract
Objective: The primary outcome was the management of acute agitation, as measured by the Richmond
Agitation-Sedation Scale (RASS). Secondary outcomes included the incidence of adverse effects and the time
to onset of the therapeutic effect.
Methods: This randomized clinical trial was conducted between March 2021 and March 2022. Participants
were recruited from patients presenting with acute agitation who required pharmacological intervention at
Emam Reza and Shahid Hasheminejad hospitals (Mashhad, Iran). Eligible participants were adults aged 18 to
65 years. Using a block randomization method with a block size of four, patients were assigned to receive either
5 mg of intravenous (IV) haloperidol or 2 mg/Kg of IV ketamine. Data were analyzed using SPSS software
(version 22).
Results: A total of 120 participants were randomized. The majority were male, comprising 43 (73%) in the
haloperidol group and 45 (75%) in the ketamine group. The mean age was 45.42±16.65 in the ketamine group
and 48.28±16.75 years in the haloperidol group (p=0.34). In the haloperidol group, the mean admission RASS
score was 1.73±0.75, which decreased to 0.07±1.25 post-intervention. In the ketamine group, the mean admission
RASS score was 1.58±0.61, which improved to -0.92±1.19 following treatment.
Conclusion: Ketamine demonstrated a faster onset of action in managing acute agitation than haloperidol.
These findings suggested that ketamine might represent a viable first-line therapeutic
Keywords
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