Therapeutic Applications of Ketamine in Emergency Medicine: Systematic Review
Suraj Gyawali, Rajeeb Raj Thapaliya, Olita Shilpakar, Shreeram Shrestha, Prasanna Rajbhandari, Prajjwal Malla, Bikash Shrestha, Shreeya Pathak
Grande Medical Journal December 22, 2025 DOI: 10.3126/gmj.v5i2.87591 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review Peer reviewed |
|---|---|
| Sample size | 18 |
| Population | Studies evaluating ketamine use in emergency settings |
| Intervention | Ketamine |
| Topics | Ketamine Esketamine |
| Keywords | Anesthetic agent Emergency department Airway management Intensive care medicine Anesthesia Hemodynamics Refractory planetary science Systematic review Endotracheal intubation Dissociative Rapid sequence induction Medline |
| Key findings | Ketamine is effective for analgesia, procedural sedation, hemodynamic stability during intubation, and managing refractory asthma and acute agitation in emergency care. |
Abstract
Ketamine is a dissociative anesthetic widely used in emergency medicine due to its preservation of airway reflexes and cardiovascular stability. A systematic review of studies published between 2000 and 2024 identified 18 relevant articles evaluating ketamine use in emergency settings. Sub-dissociative doses provide effective analgesia with opioid-sparing effects, while procedural sedation, especially in children, shows high success rates. Ketamine offers hemodynamic stability during rapid sequence intubation and is effective in refractory asthma and acute agitation, often avoiding intubation. Its affordability and stability make it valuable in resource-limited settings. Ketamine remains a versatile and evidence-based option in emergency care.
Comparable studies
Other systematic reviews and meta-analyses on ketamine, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| The effect of a single dose of intravenous ketamine on suicidal ideation: a systematic review and individual participant data meta-analysis Depressed patients with suicidal ideation at baseline | 2017 | Systematic review and individual participant data meta-analysis | n = 167 |
| Ketamine use: a review Ketamine users | 2011 | Systematic review | |
| Ketamine and Other NMDA Antagonists: Early Clinical Trials and Possible Mechanisms in Depression Participants with major depression in placebo-controlled, double-blind, randomized... | 2015 | Systematic review and meta-analysis | |
| Ketamine and postoperative pain – a quantitative systematic review of randomised trials Surgical patients from 25 countries | 2004 | Systematic review | n = 2,839 |
| Side-effects associated with ketamine use in depression: a systematic review. Patients with depression | 2018 | Systematic review |