Ketamine as an adjunct to opioids for acute pain in the ED

Ketamine appears to be a safe and effective solution for treating acute pain in the emergency department, when used to supplement opioid therapy. The single-site study involved emergency patients who continued to experience moderate-to-severe pain even after receiving opioid analgesics.

Ketamine appears to be a safe and effective solution for treating acute pain in the emergency department, when used to supplement opioid therapy. The single-site study involved emergency patients who continued to experience moderate-to-severe pain even after receiving opioid analgesics. In all, 53 participants were randomly assigned to 0.1 mg/kg of ketamine and 63 were allocated to placebo before being given additional opioid analgesia, if needed. Researchers measured pain levels, satisfaction with pain control, adverse effects, sedation level, and need for additional pain medication over the following 2-hour period. Patients in the ketamine group reported lower pain scores, needed fewer repeat doses of analgesia, and subsequently had lower overall opioid dose compared with the placebo-takers. Satisfaction with pain management was comparable with both sets of participants. Those in the ketamine cohort experienced significantly more adverse effects—including dizziness and light-headedness—but the adverse effect profile was deemed manageable.