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Intranasal Ketamine for Acute Pain
Robert J Rocchio1, Kristina E Ward
1Department of Pharmacy Practice, University of Rhode Island, Kingston, RI.
The Clinical Journal of Pain
|February 8, 2021
Summary
Intranasal ketamine shows pain relief for emergency department use but isn't superior to standard treatments and has more side effects. Further research is needed for its optimal application in acute pain management.
Area of Science:
- Emergency Medicine
- Pharmacology
- Pain Management
Background:
- Intranasal ketamine is increasingly explored for acute pain management in emergency settings.
- Evidence for its efficacy and safety across various pain conditions is still developing.
Purpose of the Study:
- To review current evidence on the off-label use of intranasal ketamine for acute pain.
- To evaluate its effectiveness in pediatric limb injuries, renal colic, digital nerve blocks, and migraines.
Main Methods:
- Systematic review of existing studies on intranasal ketamine for acute pain.
- Analysis of efficacy and adverse event profiles compared to standard treatments.
Main Results:
- Ketamine demonstrated pain reduction in all reviewed indications.
- It did not show superiority over opioids for pediatric limb injuries or renal colic.
- It was less effective than standard therapy for migraines and had more transient adverse reactions than opioids.
Conclusions:
- Current evidence is insufficient to recommend intranasal ketamine over established therapies for acute pain.
- Findings can inform dosing, adverse event management, and future research hypotheses.
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