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Khedija Zaouche1, Mohamed Kilani1, Ramla Baccouche1
1Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.
La Tunisie Medicale
|November 20, 2024
Summary
Low-dose ketamine offers effective pain relief in emergencies, comparable to morphine. While both treatments manage severe pain, ketamine showed a greater reduction in pain scores but with more side effects.
Area of Science:
- Emergency Medicine
- Pharmacology
- Pain Management
Background:
- Severe pain constitutes a medical emergency with potential life-threatening implications.
- Prompt and effective pain management is crucial in emergency settings.
Purpose of the Study:
- To compare the efficacy of low-dose ketamine versus morphine for severe pain relief.
- To evaluate analgesia outcomes in an emergency department setting.
Main Methods:
- A randomized open study included 120 adult patients with severe pain (Numeric Rating Scale [NRS] ≥6).
- Patients received either morphine (10 mg titration) or low-dose ketamine (30 mg bolus).
- The primary endpoint was achieving an NRS <4 within 10 minutes.
Main Results:
- Both morphine and low-dose ketamine groups showed similar rates of achieving NRS <4 (p=0.09).
- Low-dose ketamine resulted in a significantly lower mean NRS at 10 minutes (p=0.008).
- The low-dose ketamine group experienced a higher incidence of adverse effects (p <10-3).
Conclusions:
- Low-dose ketamine is non-inferior to morphine for severe pain analgesia in the emergency department.
- Ketamine may offer superior pain reduction but requires careful monitoring for adverse events.