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Low-dose S-ketamine for prehospital pain relief
Daniel Wittrock1,2, Lars-Gustav Rahbek Nielsen3, Henning Morthorst Lassesen2
1Prehospital Research Unit in the Region of Southern Denmark, Odense.
Danish Medical Journal
|March 3, 2026
Summary
Low-dose S-ketamine provided effective pain relief for trauma patients in a prehospital setting. Most patients reported satisfaction and would accept S-ketamine again, with few side effects.
Area of Science:
- Emergency Medicine
- Pain Management
- Pharmacology
Background:
- S-ketamine is increasingly used for prehospital traumatic pain.
- Data on patient experience and safety in civilian paramedic practice are limited.
Purpose of the Study:
- To evaluate low-dose S-ketamine, alone or with fentanyl, in a Danish prehospital setting.
- To assess pain relief, efficacy, side effects, and patient experience.
Main Methods:
- Prospective observational study of adult prehospital patients with significant trauma.
- Intravenous S-ketamine administered by paramedics, often after fentanyl.
- Pain assessed using numerical rating scale (NRS) and electronic questionnaires.
Main Results:
- 320 of 348 patients (92.0%) reported effective pain relief (median NRS reduction of 5 points).
- Hallucinations (30.0%) and diplopia (9.2%) were reported side effects.
- Hemodynamic changes were infrequent and not serious; 93.2% would accept S-ketamine again.
Conclusions:
- Low-dose S-ketamine is effective for prehospital analgesia in trauma patients.
- It is associated with infrequent, predominantly benign side effects.
- High patient satisfaction suggests good tolerability and acceptance.
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