Intranasal Ketamine Administration for Narcotic Dose Decrement in Patients Suffering from Acute Limb Trauma in Emergency Department: a Double-Blind Randomized Placebo-Controlled Trial

  • Ali Mohammadshahi Department of Emergency Medicine, AJA University of Medical Sciences, Tehran, Iran.
  • Ali Abdolrazaghnejad Department of Emergency Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. https://orcid.org/0000-0002-4121-1643
  • Hamed Nikzamir Department of Emergency Medicine, AJA University of Medical Sciences, Tehran, Iran.
  • Arash Safaie Department of Emergency Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. https://orcid.org/0000-0002-1127-6681
Keywords: Analgesics, Emergency medicine, Ketamine, Morphine, Pain management

Abstract

Introduction: pain management is an important and challenging issue in emergency medicine. Despite the conduct of several studies on this topic, pain is still handled improperly in many cases. Objective: This study investigated the effectiveness of low-dose IN ketamine administration in reducing the need for opiates in patients in acute pain resulting from limb injury. Method: This randomized, double-blind, placebo-controlled trial was conducted to assess the possible effect of low-dose intranasal (IN) ketamine administration in decreasing patients' narcotic need. Patients in emergency department suffering from acute isolated limb trauma were included. One group of patients received 0.5 mg/kg intravenous morphine sulfate and 0.02 ml/kg IN ketamine. The other group received the same dose of morphine sulfate and 0.02 ml/kg IN distilled water. Pain severity was measured using the 11 points numerical rating scale at 0, 10, 30, 60, 120, and 180 minutes. Results: Ninety-one patients with mean age of 31.62 ± 9.13 years were enrolled (54.9% male). The number of requests for supplemental medication was significantly lower in patients who received ketamine (12 patients (30%)) than those who received placebo (27 patients (67.5%)) (p = 0.001). Conclusion: It is likely that low-dose IN ketamine is effective in reducing the narcotic need of patients suffering from acute limb trauma.

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Published
2018-04-03
How to Cite
Mohammadshahi, A., Abdolrazaghnejad, A., Nikzamir, H., & Safaie, A. (2018). Intranasal Ketamine Administration for Narcotic Dose Decrement in Patients Suffering from Acute Limb Trauma in Emergency Department: a Double-Blind Randomized Placebo-Controlled Trial. Advanced Journal of Emergency Medicine, 2(3), e30. https://doi.org/10.22114/ajem.v0i0.75
Section
Original article