Patients with severe acute brain injury such as traumatic brain injury, subarachnoid haemorrhage or intracerebral haemorrhage often need to be sedated and have a breathing tube placed before they reach the hospital. In this study two medicines given through a vein are being compared: the test drug S-ketamine and the comparator drug propofol. Both are used to keep the patient calm, prevent pain and allow the tube to be placed safely.
The purpose of the study is to find out which medicine better prevents low blood pressure (hypotension) while the patient is being treated before hospital admission. Participants who need pre‑hospital sedation and ventilation are randomly given either the test drug or the comparator drug. Their blood pressure and oxygen levels are monitored from the first reading in the ambulance until they leave the trauma centre, and their recovery is checked again about six months later.
During the observation period the study records any episodes of very low or very high blood pressure, as well as low oxygen levels, and later evaluates how well patients can perform everyday activities using standard rating scales that measure functional ability. No additional procedures beyond the emergency care needed for the injury are performed as part of the study.



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