• Vikhyat S Bebarta, Alejandra G Mora, Emma K Bebarta, Lauren K Reeves, Joseph K Maddry, Steve G Schauer, and Julio R Lairet.
• 59th MDW/Chief Scientist Office, USAF En Route Care Research Center, JBSA-Lackland, TX; U.S. Army Institute of Surgical Research, Fort Sam Houston, TX, 1100 Wilford Hall Loop, JBSA-Lackland, TX 78236.
• Mil Med. 2020 Jan 7; 185 (Suppl 1): 136-142.

ObjectivesKetamine is used as an analgesic for combat injuries. Ketamine may worsen brain injury, but new studies suggest neuroprotection. Our objective was to report the outcomes of combat casualties with traumatic brain injury (TBI) who received prehospital ketamine.MethodsThis was a post hoc, sub-analysis of a larger prospective, multicenter study (the Life Saving Intervention study [LSI]) evaluating prehospital interventions performed in Afghanistan. A DoD Trauma Registry query provided disposition at discharge and outcomes to be linked with the LSI data.ResultsFor this study, we enrolled casualties that were suspected to have TBI (n = 160). Most were 26-year-old males (98%) with explosion-related injuries (66%), a median injury severity score of 12, and 5% mortality. Fifty-seven percent (n = 91) received an analgesic, 29% (n = 46) ketamine, 28% (n = 45) other analgesic (OA), and 43% (n = 69) no analgesic (NA). The ketamine group had more pelvic injuries (P = 0.0302) and tourniquets (P = 0.0041) compared to OA. In comparison to NA, the ketamine group was more severely injured and more likely to require LSI procedures, yet, had similar vital signs at admission and disposition at discharge.ConclusionsWe found that combat casualties with suspected TBI that received prehospital ketamine had similar outcomes to those that received OAs or NAs despite injury differences.© Association of Military Surgeons of the United States 2020. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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