Abstract
Objectives
The aim of this study was to describe the use and effect of low-dose ketamine (LDK)
for analgesia in the emergency department (ED).
Methods
A chart review was performed to identify all adult patients who received LDK for analgesia
in our ED. Cases were identified by pharmacy record of ketamine administration. Low-dose
ketamine was defined as the administration of 0.1 to 0.6 mg/kg of ketamine for pain
control. Use of ketamine during procedural sedation was excluded. Data were analyzed
descriptively.
Results
Thirty-five cases in which patients received LDK in the ED for a 2-year period were
identified. Doses ranged from 5 to 35 mg. Administration was intravenous in 30 (86%)
of 35 cases and intramuscular in 5 (14%) of 35 cases. Opioids were administered before
or coadministered with LDK in 32 (91%) of 35 cases, and in the remaining 3 cases,
opioids were used before the patient came to the ED. Improvement in pain was observed
in 19 (54%) of 35 cases in which patients received LDK. Pain scores did not improve
in 8 (23%) of 35 cases. Insufficient data were available to determine LDK effect for
8 (23%) of 35 cases. No significant adverse events were identified in any of the 35
cases.
Conclusions
The administration of LDK in the ED may be a safe and effective adjunct for analgesia
in some patients. However, prospective randomized controlled trials are needed before
widespread use of LDK for analgesia in the ED can be recommended.
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Article Info
Publication History
Published online: April 05, 2010
Accepted:
July 30,
2009
Received in revised form:
July 30,
2009
Received:
January 5,
2009
Footnotes
☆Computer funding provided by the Department of Emergency Medicine, University of New Mexico.
☆☆Abstract presented at the SAEM Western Regional Research Forum, March 2007, Portland, OR.
Identification
Copyright
© 2010 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
