TY - JOUR
T1 - Low-dose ketamine for analgesia in the ED
T2 - A retrospective case series
AU - Lester, Laeben
AU - Braude, Darren A.
AU - Niles, Christopher
AU - Crandall, Cameron S.
PY - 2010/9
Y1 - 2010/9
N2 - 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.
AB - 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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U2 - 10.1016/j.ajem.2009.07.023
DO - 10.1016/j.ajem.2009.07.023
M3 - Article
C2 - 20837262
AN - SCOPUS:77956598680
SN - 0735-6757
VL - 28
SP - 820
EP - 827
JO - American Journal of Emergency Medicine
JF - American Journal of Emergency Medicine
IS - 7
ER -