Historical comparison is weaker than a concurrent randomized comparison.
What the paper found
A retrospective series described thirty ventilated adults receiving prolonged ketamine sedation. Four patients changed sedatives because of possible adverse effects. The discussion compared the experience with concerns about more commonly used sedatives, including midazolam.
What the evidence cannot establish
There was no concurrent benzodiazepine control group, and patients dying before the minimum exposure duration were excluded. That selection affects which events the series can describe.
Implications for forensic review
Do not interpret the reported event frequency as a head-to-head safety estimate. Specify inclusion criteria and the reason ketamine was chosen. The paper can inform a discussion of alternatives, but cannot establish that a benzodiazepine caused an adverse event that ketamine would have prevented.
Source and related reading
Source: PMC4335149, supplied full-text paper. Findings are paraphrased; case-review implications are an interpretation.
Related: A Hospital Fall Series Without Nonfalling Controls Cannot Rank the Risk of Individual Sleeping Pills.
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