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[Analgetic ketamine feasible in ambulance emergency care]
R P Ansem1, J A Hartman, J F Foudraine
1Academisch Ziekenhuis Rotterdam-Dijkzigt, afd. Spoedeisende Hulp.
Objective:
To investigate if ketamine could be a feasible analgetic in ambulance trauma care.
Design:
Prospective.
Setting:
University Hospital of Rotterdam 'Dijkzigt'.
Methods:
To 51 women and 87 men in the age of 9-95 years who suffered from pain due to trauma and needed pain relief during transport to the hospital, a low dose of ketamine was given according to protocol. Their pain was measured with a descriptive verbal pain scale every 5 minutes.
Results:
Upon arrival in the hospital 125 (90.5%) out of the 138 patients had a relief of their pain. For 101 patients the pain was only minimal or had disappeared during transport. This was reached in 74 cases with only one dose of ketamine, in 26 cases a second dose was needed, a same number needed nitrous oxide in addition and 9 times a second dose and nitrous oxide was given. Side-effects were mostly of psychic origin, such as agitation (9%), disorientation (17%), sedation (27%), and hallucinations (5%). They never lasted longer than several minutes or hindered further investigation.
Conclusion:
A low dose ketamine seems a safe and feasible analgetic in ambulance trauma care. Further research which compares ketamine with other in the ambulance trauma care current analgetics seems of value.