A retrospective study of ketamine administration and the development of acute or post ‐traumatic stress disorder in 274 war‐wounded soldiers

The objective of this study was to explore whether ketamine prevents or exacerbates acute or post‐traumatic stress disorders in military trauma patients. We conducted a retrospective study of a database from the French Military Health Service, including all soldiers surviving a war injury in Afghanistan (2010–2012). The diagnosis of post‐traumatic stress disorder was made by a psychiatrist and patients were analysed according to the presence or absence of this condition. Analysis included the following covariables: age; sex; acute stress disorder; blast injury; associated fatality; brain injury; traumatic amputation; Glasgow coma scale; injury severity score; administered drugs; number of surgical procedures; physical, neurosensory or aesthetic sequelae; and the development chronic pain. Covariables related to post‐traumatic and acute stress disorders with a p ≤ 0.10 were included in a multivariable logistic regression model. The data from 450 soldiers were identified; 399 survived, of which 274 were analysed. Among these, 98 (36%) suffered from post‐traumatic stress disorder and 89 (32%) had received ketamine. Fifty‐four patients (55%) in the post‐traumatic stress disorder group received ketamine vs. 35 (20%) in the no PTSD group (p < 0.001). The 89 injured soldiers who received ketamine had a median (IQR [range]) injury severity score of 5 (3–13 [1–26]) vs. 3 (2–4 [1–6] in the 185 patients who did not (p < 0.001). At multivariable analysi...
Source: Anaesthesia - Category: Anesthesiology Authors: Tags: Original Article Source Type: research