SynthesisCNS drugs2018
Ketamine for Refractory Status Epilepticus: A Systematic Review.
Synthesis in CNS drugs, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 40 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Efficacy of Ketamine in Refractory Convulsive Status Epilepticus in Children: a Multicenter, Randomized, Controlled, Open-label, No-profit, With Sequential Design Study.
Efficacy of Ketamine Infusion Compared With Traditional Anti-epileptic Agents in Refractory Status Epilepticus- a Pilot Study
A Pilot Study to Assess the Efficacy of Subanesthetic Doses of IV Ketamine in the Treatment Drug Resistant Epilepsy
Who cites it
40 citing papers in PubMed, 4 syntheses or guidelines pooled it, 82 citations in OpenAlex.
- Effect of Perioperative Ketamine and Esketamine on Postoperative Fatigue: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Medicina (Kaunas, Lithuania) · 2026Pooled it
- Ketamine use in the refractory and super refractory status epilepticus: a systematic review.Frontiers in medicine · 2026Pooled it
- Electroencephalography Correlation of Ketamine-induced Clinical Excitatory Movements: A Systematic Review.The western journal of emergency medicine · 2025Pooled it
- Pooled it
- Efficacy of Home Anticonvulsant Administration for Second-Line Status Epilepticus Treatment.Neurology · 2021Trial
- Effects of general anesthetics on seizure termination, mortality, and neurological prognosis in a rat model of pediatric refractory status epilepticus: A comparative randomized controlled study.Journal of advanced research · 2026Article
- Ketamine in super-refractory status epilepticus: Combined value of inflammatory biomarkers and EEG features.Epilepsia · 2026Observational
- Ketamine Dosing Across Clinical Indications: A Narrative Review Organized by Proposed NMDA-Related Mechanisms.Journal of clinical pharmacology · 2026Review
- Synaptic inhibitory dynamics drive benzodiazepine response in pediatric status epilepticus.Epilepsia · 2025Article
- Review
- Prognostic factors and impact of management strategies for status epilepticus: The STEPPER study in the Emilia-Romagna region, Italy.Epilepsia · 2025Observational
- General Anesthetics: Aspects of Chirality, Pharmacodynamics, and Pharmacokinetics.Pharmaceuticals (Basel, Switzerland) · 2025Review
- Treatment of convulsive status epilepticus in Brazil: a review.Arquivos de neuro-psiquiatria · 2025Review
- Effectiveness of Ketamine As a Rescue Drug for Patients Experiencing Benzodiazepine-Resistant Status Epilepticus in the Prehospital Setting.Critical care explorations · 2024Observational
- Use of ketamine in Super Refractory Status Epilepticus: a systematic review.Neurological research and practice · 2024Review
- Ketamine to Prevent Endotracheal Intubation in Adults with Refractory Non-convulsive Status Epilepticus: A Case Series.Neurocritical care · 2024Article
- A Comparison of Ketamine and Midazolam as First-Line Anesthetic Infusions for Pediatric Status Epilepticus.Neurocritical care · 2024Article
- Multicenter Retrospective Review of Ketamine Use in Pediatric Intensive Care Units (Ketamine-PICU Study).Critical care research and practice · 2024Article
- Evidence-based guideline on management of status epilepticus in adult intensive care unit in resource-limited settings: a review article.Annals of medicine and surgery (2012) · 2023Article
- Status Epilepticus in Older Adults: Diagnostic and Treatment Considerations.Drugs & aging · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundKetamine is an emerging third-line medication for refractory status epilepticus, a medical and neurological emergency requiring prompt and appropriate treatment. Owing to its pharmacological properties, ketamine represents a practical alternative to conventional anaesthetics.
objectiveThe objective of this study was to assess the efficacy and safety of ketamine to treat refractory status epilepticus in paediatric and adult populations.
methodsWe conducted a literature search using the PubMed database, Cochrane Database of Systematic Reviews and ClinicalTrials.gov website.
resultsWe found no results from randomised controlled trials. The literature included 27 case reports accounting for 30 individuals and 14 case series, six of which included children. Overall, 248 individuals (29 children) with a median age of 43.5 years (range 2 months to 67 years) were treated in 12 case series whose sample size ranged from 5 to 67 patients (median 11). Regardless of the status epilepticus type, ketamine was twice as effective if administered early, with an efficacy rate as high as 64% in refractory status epilepticus lasting 3 days and dropping to 32% when the mean refractory status epilepticus duration was 26.5 days. Ketamine doses were extremely heterogeneous and did not appear to be an independent prognostic factor. Endotracheal intubation, a negative prognostic factor for status epilepticus, was unnecessary in 12 individuals (10 children), seven of whom were treated with oral ketamine for non-convulsive status epilepticus.
conclusionsAlthough ketamine has proven to be effective in treating refractory status epilepticus, available studies are hampered by methodological limitations that prevent any firm conclusion. Results from two ongoing studies (ClinicalTrials.gov identification number: NCT02431663 and NCT03115489) and further clinical trials will hopefully confirm the better efficacy and safety profile of ketamine compared with conventional anaesthetics as third-line therapy in refractory status epilepticus, both in paediatric and adult populations.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.