Response to letter to the editor

In reply,We read Payandemehr's letter with great interest and thank you forthe opportunity to respond to the comments. In our study,1 whichcompared two different doses of intravenous (IV) ketamine (0.5 mg/kgvs. 1 mg/kg) for procedural sedation in adults, the incidence of re-covery agitation was 20.4% in patients who received 0.5 mg/kg and22.2% in those who received 1 mg/kg. In contrast, Payandemehret al.1 reported a recovery agitation incidence of 63.9% in the 1 mg/kg group, measured using the Pittsburgh Agitation Scale (PAS). Inthe same study,2 they defined clinically significant agitation as a PASscore ≥3 in at least one dimension, which was observed in 26.2% ofpatients. We agree with the factors proposed by Payandemehr toexplain the discrepancy in recovery agitation rates across studies.One key difference is the assessment tools used: we employed theRichmond Agitation–Sedation Scale (RASS), whereas Payandemehret al. used PAS. This alone may contribute to variation in reportedrecovery agitation rates.