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Intraveneous ketamine
exhibits a favorable efficacy and safety profile, therefore it's use should be
considered in patients repeatedly presented to the ED with a painful condition.
According to Academic
Emergency Medicine, a Systematic Review and Meta-analysis highlighted that
Ketamine is not inferior to morphine for easing acute pain. It indicated that
ketamine could be considered as a substitute to opioids for ED short-term pain
control.
For acute pain treatment, opioids are usually prescribed in the emergency
department (ED). Analgesic substitutes are being investigated in response to an
epidemic of opioid misuse. One such opioid substitute is the Low-dose ketamine
(LDK) for the acute pain treatment in the ED.
Karlow N et al. performed a
systematic review and meta-analysis to explain whether LDK is an efficacious
and safe opioid substitute to reduce acute pain in adults in the ED setting.
In this systematic review of randomized controlled trials, intravenous opioids
were compared to LDK for acute pain relief in the ED. The studies where the
control group primarily received opioids prior to ketamine were not considered.
An electronic search technique was designed by a research librarian. The
changes in visual analog scale (VAS) or numeric rating scale (NRS) pain scales
were examined to determine the relative effects of LDK and opioids in the
treatment of acute pain.
In this meta-analysis, 3
studies met the inclusion criteria. Ketamine was not inferior (relative
reduction = 0.42, 95% confidence interval = -0.70 to 1.54) as compared to to
pain scale reduction with morphine. All in all, no severe adverse events were
reported in any study, but higher rates of non-severe adverse events were
noticed with ketamine. Thus it was concluded that the low dose ketamine can be
considered as an alternative to opioids for Emergency Department short-term
pain control.
Acad Emerg Med. 2018 Jul 17.
A Systematic Review and Meta-analysis of Ketamine as an Alternative to Opioids for Acute Pain in the Emergency Department
Karlow N et al.
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