Rapid Improvement in Consciousness After Low-Dose Ketamine in a Patient With Acute Confusion: A Case Report

Ketamine, widely used for procedural sedation, may possess underrecognized neuroprotective and cognitive-modulating effects. We report the case of a 66-year-old female patient who presented with acute confusion (Glasgow Coma Scale (GCS) 12/15; E3V4M5), likely secondary to a urinary tract infection. Remarkably, she regained full consciousness (GCS 15/15; E4V5M6) within 45 minutes of receiving 40 mg of intravenous ketamine for nasogastric tube insertion. No other sedatives or interventions were administered during this period. This observation raises the possibility that ketamine may play a role in rapidly reversing acute confusion and enhancing arousal in select clinical scenarios. While anecdotal, such findings align with emerging literature and warrant further exploration of ketamine's neurocognitive effects beyond its established indications.