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Forschungsdatenbank PMU-SQQUID

(S)-Ketamine in Refractory and Super-Refractory Status Epilepticus: A Retrospective Study.
Höfler, J; Rohracher, A; Kalss, G; Zimmermann, G; Dobesberger, J; Pilz, G; Leitinger, M; Kuchukhidze, G; Butz, K; Taylor, A; Novak, H; Trinka, E;
CNS Drugs. 2016; 30(9):869-876
Originalarbeiten (Zeitschrift)


Astner-Rohracher Alexandra
Butz Kevin Holger Gerd
Dobesberger Judith
Höfler Julia
Kalss Gudrun
Kuchukhidze Giorgi
Leitinger Markus
Novak Helmut
Pilz Georg
Trinka Eugen
Zimmermann Georg Johannes


The aim was to describe the safety and efficacy of (S)-ketamine [(S)-KET] in a series of patients with refractory and super-refractory status epilepticus (RSE and SRSE) in a specialized neurological intensive care unit (NICU).
We retrospectively analyzed the data of patients with RSE and SRSE treated with (S)-KET in the NICU, Salzburg, Austria, from 2011 to 2015. Data collection included demographic features, clinical presentation, diagnosis, electroencephalogram (EEG) data, anticonvulsant treatment, timing, and duration of treatment with (S)-KET. Outcomes were seizure control and death.
A total of 42 patients (14 women) with RSE and SRSE were treated with (S)-KET. The median duration of status epilepticus (SE) was 10 days [first quartile (Q1) 5.0, Q3 21.0]; the median latency from SE onset to the first administration of (S)-KET was 3 days (Q1 2.0, Q3 6.8). Prior to (S)-KET administration, patients had received a median of two (Q1 2.0, Q3 3.0) anesthetics and three (Q1 2.0, Q3 4.0) antiepileptic drugs. Forty percent of patients (17/42) received propofol: 65 % prior to (S)-KET; 35 % at the same time with (S)-KET. Seven patients received a median bolus of (S)-KET of 200 mg (Q1 200, Q3 250) followed by a continuous infusion, while 35 started with a continuous infusion (maximum rate median 2.55 mg/kg/h; Q1 2.09, Q3 3.22). In 64 % of patients (27/42), (S)-KET was the last drug before SE cessation; in five patients, it was given with propofol at the same time. Median duration of administration was 4 days (Q1 2.0, Q3 6.8). Overall (S)-KET treatment was well tolerated, adverse effects were not observed, and overall mortality was 45.2 %.
Treatment of SRSE in adult patients with (S)-KET led to resolution of status in 64 %. No adverse events were found, indicating a favorable safety profile.

Useful keywords (using NLM MeSH Indexing)






Drug Resistant Epilepsy/drug therapy*


Excitatory Amino Acid Antagonists/administration*


Excitatory Amino Acid Antagonists/adverse effects



Intensive Care Units



Ketamine/adverse effects


Middle Aged



Retrospective Studies

Status Epilepticus/drug therapy*

Treatment Outcome