Low-dose Ketamine Improves Pain Relief in Patients Receiving Intravenous Opioids for Acute Pain in the Emergency Department: Results of a Randomized, Double-blind, Clinical Trial

Academic Emergency Medicine

Volumn 21, Issue 11, 2014, Pages 1193-1202

  Beaudoin, Francesca L ^a   Lin, Charlie ^a   Guan, Wentao ^a   Merchant, Roland C ^a  

^a BROWN UNIVERSITY   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

KETAMINE; MORPHINE; PLACEBO; SODIUM CHLORIDE; ANALGESIC AGENT; NARCOTIC ANALGESIC AGENT;

ADULT; AGED; ANALGESIA; ARTICLE; CLINICAL ASSESSMENT; CLINICAL EFFECTIVENESS; CLINICAL EVALUATION; COMPARATIVE EFFECTIVENESS; CONFUSION; CONTROLLED STUDY; DIZZINESS; DOUBLE BLIND PROCEDURE; DYSPHORIA; EMERGENCY WARD; FEMALE; HUMAN; LOW DRUG DOSE; MAJOR CLINICAL STUDY; MALE; NAUSEA; NUMERICAL PAIN RATING SCALE; OPIOID INDUCED EMESIS; OUTCOME ASSESSMENT; PAIN; PAIN ASSESSMENT; PAIN INTENSITY; PAIN PARAMETERS; PAIN SEVERITY; RANDOMIZED CONTROLLED TRIAL; RATING SCALE; SELF CONCEPT; VISUAL DISORDER; VOMITING; ACUTE PAIN; DOSE RESPONSE; EMERGENCY HEALTH SERVICE; FOLLOW UP; INTRAVENOUS DRUG ADMINISTRATION; PAIN MEASUREMENT; PILOT STUDY; PROCEDURES; RETROSPECTIVE STUDY; TIME; TREATMENT OUTCOME;

ACUTE PAIN; ADULT; ANALGESIA; ANALGESICS; ANALGESICS, OPIOID; DOSE-RESPONSE RELATIONSHIP, DRUG; DOUBLE-BLIND METHOD; EMERGENCY SERVICE, HOSPITAL; FEMALE; FOLLOW-UP STUDIES; HUMANS; INFUSIONS, INTRAVENOUS; INJECTIONS, INTRAVENOUS; KETAMINE; MALE; PAIN MANAGEMENT; PAIN MEASUREMENT; PILOT PROJECTS; RETROSPECTIVE STUDIES; TIME FACTORS; TREATMENT OUTCOME;

EID: 84911999469     PISSN: 10696563     EISSN: 15532712     Source Type: Journal    
DOI: 10.1111/acem.12510     Document Type: Article

References (21)

1. Chang AK, Bijur PE, Napolitano A, Lupow J, Gallagher EJ,. Two milligrams i.v. hydromorphone is efficacious for treating pain but is associated with oxygen desaturation. J Opioid Manag 2009; 5: 75-80.
2. Bijur PE, Kenny MK, Gallagher EJ,. Intravenous morphine at 0.1 mg/kg is not effective for controlling severe acute pain in the majority of patients. Ann Emerg Med 2005; 46: 362-7.
3. Mao J,. NMDA and opioid receptors: their interactions in antinociception, tolerance and neuroplasticity. Brain Res Brain Res Rev 1999; 30: 289-304.
4. Petrenko AB, Yamakura T, Baba H, Shimoji K,. The role of N-methyl-D-aspartate (NMDA) receptors in pain: a review. Anesth Analg 2003; 97: 1108-16.
5. Gupta LK, Gupta R, Tripathi CD,. N-Methyl-D-aspartate receptor modulators block hyperalgesia induced by acute low-dose morphine. Clin Exp Pharmacol Physiol 2011; 38: 592-7.
6. Bell RF, Dahl JB, Moore RA, Kalso E,. Perioperative ketamine for acute postoperative pain. Cochrane Datab System Rev 2006;(1): CD004603.
7. Godwin SA, Burton JH, Gerardo CJ, et al. Clinical policy: procedural sedation and analgesia in the emergency department. Ann Emerg Med 2014; 63: 247-58.
8. Richards JR, Rockford RE,. Low-dose ketamine analgesia: patient and physician experience in the ED. Am J Emerg Med 2013; 31: 390-4.
9. Andolfatto G, Willman E, Joo D, et al. Intranasal ketamine for analgesia in the emergency department: a prospective observational series. Acad Emerg Med 2013; 20: 1050-4.
10. Ahern TL, Herring AA, Stone MB, Frazee BW,. Effective analgesia with low-dose ketamine and reduced dose hydromorphone in ED patients with severe pain. Am J Emerg Med 2013; 31: 847-51.
11. Lester L, Braude DA, Niles C, Crandall CS,. Low-dose ketamine for analgesia in the ED: a retrospective case series. Am J Emerg Med 2010; 28: 820-7.
12. Johansson P, Kongstad P, Johansson A,. The effect of combined treatment with morphine sulphate and low-dose ketamine in a prehospital setting. Scand J Trauma Resusc Emerg Med 2009; 17: 61.
13. Farrar JT, Portenoy RK, Berlin JA, Kinman JL, Strom BL,. Defining the clinically important difference in pain outcome measures. Pain 2000; 88: 287-94.
14. Farrar JT, Berlin JA, Strom BL,. Clinically important changes in acute pain outcome measures: a validation study. J Pain Symptom Manage 2003; 25: 406-11.
15. Dai F, Silverman DG, Chelly JE, Li J, Belfer I, Qin L,. Integration of pain score and morphine consumption in analgesic clinical studies. J Pain 2013; 14: 767-77.
16. Schulz KF, Altman DG, Moher D, for the Consort Group. CONSORT. statement: updated guidelines for reporting parallel group randomised trials. BMJ 2010; 2010 (340): c332.
17. Galinski M, Dolveck F, Combes X, et al. Management of severe acute pain in emergency settings: ketamine reduces morphine consumption. Am J Emerg Med 2007; 25: 385-90.
18. Jennings PA, Cameron P, Bernard S, et al. Morphine and ketamine is superior to morphine alone for out-of-hospital trauma analgesia: a randomized controlled trial. Ann Emerg Med 2012; 59: 497-503.
19. Herring AA, Ahern T, Stone MB, Frazee BW,. Emerging applications of low-dose ketamine for pain management in the ED. Am J Emerg Med 2013; 31: 416-9.
20. Uprety D, Baber A, Foy M,. Ketamine infusion for sickle cell pain crisis refractory to opioids: a case report and review of literature. Ann Hematol 2014; 93: 769-71.
21. Bijur PE, Esses D, Chang AK, Gallagher EJ,. Dosing and titration of intravenous opioid analgesics administered to ED patients in acute severe pain. Am J Emerg Med 2012; 30: 1241-4.