Journal of Trauma and Injury

Review Article

The impact of ketamine on posttraumatic stress disorder (PTSD) symptomatology in trauma-exposed populations: a narrative review: Minaal Ahmed Malik, Michele Halasa, Jack Chia, Venera Derguti, Holly Hathway, Fahad Hussain, Abdel Saad; J Trauma Inj. 2026;39(2):119-127. Published online April 2, 2026; DOI: https://doi.org/10.20408/jti.2025.0086

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Abstract PDF: Ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, is widely used in trauma and emergency medicine for its rapid analgesic and sedative properties. While its efficacy in acute pain management is well established, concerns persist regarding its long-term psychological effects, particularly its potential role in the development of posttraumatic stress disorder (PTSD). Some studies indicate that ketamine may provide rapid symptom relief in PTSD, whereas others raise concerns about its contribution to dissociative states and maladaptive memory consolidation. This narrative review examines existing literature on ketamine’s influence on PTSD symptomatology in trauma-exposed populations. A comprehensive assessment of randomized controlled trials and observational studies was undertaken to explore ketamine’s effects on dissociation, memory processing, and long-term psychiatric outcomes. Relevant studies were identified from major medical databases, and findings were synthesized to present an integrated overview of ketamine’s psychological impact in trauma care settings. Clinical trials suggest that a single intravenous infusion of ketamine (0.5 mg/kg) may significantly reduce PTSD symptoms within 24 hours compared to midazolam, with improvements in overall clinical presentation and no lasting dissociative effects. Conversely, some observational studies have linked ketamine use in acute trauma care to heightened dissociation, hyperarousal, and stress symptoms during early follow-up. Research on burn patients receiving intraoperative ketamine suggests a possible reduction in PTSD incidence, although a later study reported no significant difference compared with non-ketamine controls. The relationship between ketamine and PTSD is complex, with effects appearing to depend on dose and timing of administration. While perioperative ketamine may confer protective benefits against long-term psychiatric sequelae, immediate post-trauma administration may worsen dissociative symptoms and acute stress responses. Further well-controlled clinical trials are needed to refine dosing protocols and identify patient-specific risk factors, including preexisting psychiatric conditions, to better guide its use.; Summary

Original Articles

Prevalence of posttraumatic stress disorder in orthopedic trauma patients and a call to implement the Injured Trauma Survivor Screen as a prospective screening protocol in the United States: Victoria J. Nedder, Mary A. Breslin, Vanessa P. Ho, Heather A. Vallier; J Trauma Inj. 2024;37(1):67-73. Published online February 23, 2024; DOI: https://doi.org/10.20408/jti.2023.0068

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Purpose
Posttraumatic stress disorder (PTSD) is prevalent and is associated with protracted recovery and worse outcomes after injury. This study compared PTSD prevalence using the PTSD checklist for DSM-5 (PCL-5) with the prevalence of PTSD risk using the Injured Trauma Survivor Screen (ITSS).
Methods
Adult trauma patients at a level I trauma center were screened with the PCL-5 (sample 1) at follow-up visits or using the ITSS as inpatients (sample 2).
Results
Sample 1 (n=285) had significantly fewer patients with gunshot wounds than sample 2 (n=45) (8.1% vs. 22.2%, P=0.003), nonsignificantly fewer patients with a fall from a height (17.2% vs. 28.9%, P=0.06), and similar numbers of patients with motor vehicle collision (40.7% vs. 37.8%, P=0.07). Screening was performed at a mean of 153.9 days following injury for sample 1 versus 7.1 days in sample 2. The mean age of the patients in sample 1 was 45.4 years, and the mean age of those in sample 2 was 46.1 years. The two samples had similar proportions of female patients (38.2% vs. 40.0%, P=0.80). The positive screening rate was 18.9% in sample 1 and 40.0% in sample 2 (P=0.001). For specific mechanisms, the positive rates were as follows: motor vehicle collisions, 17.2% in sample 1 and 17.6% in sample 2 (P=1.00); fall from height, 12.2% in sample 1 and 30.8% in sample 2 (P=0.20); and gunshot wounds, 39.1% in sample 1 and 80.0% in sample 2 (P=0.06).
Conclusions
The ITSS was obtained earlier than PCL-5 and may identify PTSD in more orthopedic trauma patients. Differences in the frequency of PTSD may also be related to the screening tool itself, or underlying patient risk factors, such as mechanism of injury, or mental or social health.

Summary

Citations

Citations to this article as recorded by

The prevalence and risk factors of posttraumatic stress disorder following road traffic accidents in China: A meta-analysis
Yanna Zhou, Juanita A Haagsma, Jan Busschbach, Rong Zeng, Zhihao Yang, Jindong Ding Petersen, Xiuquan Shi
Traffic Injury Prevention.2026; 27(5): 526. CrossRef
Musculoskeletal Clinicians’ Perspectives on Integrated Digital Personalized Feedback Interventions to Address Risky Alcohol use and PTSD after Musculoskeletal Injury
Jafar Bakhshaie, Sina Ramtin, Jonathan Greenberg, Arun Aneja, Thuan Ly, Anka Vujanovic, David Ring, Michael Zvolensky
Journal of Clinical Psychology in Medical Settings.2026; 33(2): 346. CrossRef
Alcohol Misuse, Posttraumatic Stress Symptoms, and Recovery After Musculoskeletal Injury: Implications for Effective Orthopaedic Care
Jafar Bakhshaie, Michael J. Zvolensky, Anka A. Vujanovic, Joseph W. Ditre, David Ring
Journal of the American Academy of Orthopaedic Sur.2026; 34(10): e1359. CrossRef
Psychological factors influencing pain perception in orthopedic trauma patients
Dr. Krishna Shah, Dr. Bindulata Maurya, Dr. Ajay V Shenoy, Yusra Farooq, Dr. Abhilekha Biswal, Dr. Rakesh Kumar Yadav, Dr. Richa Gupta
PAIN, JOINTS, SPINE.2026; : 94. CrossRef

One year of treating patients with open fractures of the lower extremity in a new military trauma center in Korea: a case series: Ji Wool Ko, Giho Moon, Jin Geun Kwon, Kyoung Eun Kim, Hankaram Jeon, Kyungwon Lee; J Trauma Inj. 2023;36(4):376-384. Published online December 19, 2023; DOI: https://doi.org/10.20408/jti.2023.0041

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Abstract PDF

Purpose
The Armed Forces Trauma Center of Korea was established in April 2022. This study was conducted to report our 1-year experience of treating soldiers with open fractures of the lower extremity.
Methods
In this case series, we reviewed the medical records of 51 Korean soldiers with open fractures of the lower extremity between April 2022 and March 2023 at a trauma center. We analyzed patients with Gustilo-Anderson type II and III fractures and reported the duration of transportation, injury mechanisms, injured sites, and associated injuries. We also presented laboratory findings, surgery types, intensive care unit stays, hospital stays, rehabilitation results, and reasons for psychiatric consultation. Additionally, we described patients’ mode of transport.
Results
This study enrolled nine male patients who were between 21 and 26 years old. Six patients had type II and three had type III fractures. Transport from the accident scene to the emergency room ranged from 75 to 455 minutes, and from the emergency room to the operating room ranged from 35 to 200 minutes. Injury mechanisms included gunshot wounds, landmine explosions, grenade explosions, and entrapment by ship mooring ropes. One case had serious associated injuries (inhalation burn, open facial bone fractures, and hemopneumothorax). No cases with serious blood loss or coagulopathies were found, but most cases had a significant elevation of creatinine kinase. Two patients underwent vascular reconstruction, whereas four patients received flap surgery. After rehabilitation, six patients could walk, one patient could move their joints actively, and two patients performed active assistive movement. Eight patients were referred to the psychiatry department due to suicidal attempts and posttraumatic stress disorder.
Conclusions
This study provides insights into how to improve treatment for patients with military trauma, as well as medical services such as the transport system, by revising treatment protocols and systematizing treatment.

Summary

Citations

Citations to this article as recorded by

The PTSD-Bone Axis: Evidence, Mechanisms, and Management
Olivia X. Jones, Kirsten D. Kelly, Stephanie K. Khoo, Ryan R. Kelly, Sara J. Sidles, Amanda C. LaRue
Current Osteoporosis Reports.2026;[Epub] CrossRef
Changes in the characteristics of civilian patients admitted to a military hospital before and during the healthcare system crisis: a retrospective cohort study
Changsin Lee, Sang Mok Lee, Kyungwon Lee
Journal of Trauma and Injury.2026; 39(1): 14. CrossRef
Injuries from blank cartridge shots in suicide attempts within the South Korean military: a case series of five patients
Jeong Il Joo, Changsin Lee, Kyungwon Lee
Journal of Trauma and Injury.2024; 37(4): 262. CrossRef

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