Post-traumatic stress disorder or emergence phenomena? A case of psychomotor agitation after procedural sedation and analgesia.
Drug Metab Pers Ther
; 34(4)2019 12 18.
Article
in En
| MEDLINE
| ID: mdl-31874096
ABSTRACT
Background Psychomotor agitation can be problematic in an overcrowded emergency department (ED) during uncontrolled procedural sedation. Although emergence phenomena have been studied, various presentations may exist. Case presentation During procedural sedation, a 58-year-old man was sedated with a dissociative dose of ketamine in conjunction with propofol. His shoulder dislocation was reduced successfully but eventually, an exaggerated agitation occurred resembling a post-traumatic stress disorder (PTSD) flashback of past war scenes He was controlled by physical and chemical restraint with an intramuscular injection of 0.1 mg/kg midazolam. After resolution of sedation in rather stable psychiatric conditions, he left the ED with his relatives insisting for discharge against medical advice. Conclusions A PTSD flashback may occur from ketamine sedation in patients with a past history of military experience and can be a manifestation of psychologic adverse effects of ketamine.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Psychomotor Agitation
/
Stress Disorders, Post-Traumatic
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Conscious Sedation
/
Analgesia
Limits:
Humans
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Male
/
Middle aged
Language:
En
Journal:
Drug Metab Pers Ther
Year:
2019
Document type:
Article
Affiliation country:
Iran