Abstract
Background
Low dose ketamine can be used as analgesic in acute pain management in the emergency
department (ED).
Objective
Efficacy of IN ketamine in acute pain management in the ED.
Method
This is a double blind randomized clinical trial on patients older than 15 years who
needed digital nerve block (DNB). Participants randomly received IN Ketamine (1 ml = 50 mg)
or placebo (normal saline, 1 ml) 5 min before DNB. In both groups, patients' pain
score was recorded by visual analogue score (VAS) at baseline, after DNB and 45 min
after completion of DNB. Adverse effects of ketamine and changes in vital signs were
also recorded and compared with placebo group.
Results
A total number of 100 patients were enrolled in the study with the median (IQR) age
of 36.5 (26) years, including 65 men and 35 women. IN ketamine resulted in less pain
compared to placebo after performing DNB and 45 min after the procedure. Median (IQR)
basic VAS score was 50 (15) in ketamine group, and 49 (27) in control group. Median
(IQR) block pain VAS score was 28.5 (19) in ketamine group and 47.5 (31) in control
group. Median (IQR) procedural pain VAS score was 21.5 (16) in ketamine group and
43.5 (29) in control group. Only 7 patients had adverse effects in either group.
Conclusion
The findings of this study suggest that IN ketamine can be effective in reducing pain
in patients with acute pain, without adding significant side effects.
Keywords
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Article Info
Publication History
Published online: November 17, 2018
Accepted:
November 17,
2018
Received in revised form:
November 12,
2018
Received:
April 25,
2018
Footnotes
☆IRCT registration number: IRCT201206289162N3.
☆Ethics committee reference number: 1935/130/D/91.
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
