Intranasal ketamine as an analgesic agent for acute pain management in emergency department: A literature review
Journal Title: Journal of Acute Disease - Year 2018, Vol 7, Issue 6
Abstract
Ketamine is a well-known dissociative anesthetic agent, and has been used over 50 years. Intranasal pathway is a mucosal way for absorbing agents to directly affect in brain via olfactory sheets, bypassing first pass metabolism and the blood brain barrier. The current uses of intranasal ketamine as an analgesic agent for acute pain management in emergency department are discussed in this review article. Using “ketamine”, “pain or analgesia”, and “intranasal” as keywords, a search of google scholar, Pubmed, web of science, and Medline database from 1970 until 2017 was performed. Finally, from 1 204 papers extracted via primary search, 1 088 papers were omitted and finally 10 studies were considered for further assessment. There were four observational studies, one case series and report and 5 clinical trials. Ketamine was used for acute pain control due to musculoskeletal trauma, burns, and painful procedures. A total of 390 cases were included in these studies. The studies used ketamine with doses ranging 0.45-1.25 mg/kg via intranasal pathway. Intranasal ketamine provides relatively rapid, well tolerated, and clinically significant analgesia for emergency department patients. Considering the lack of adequate studies and undetermined intranasal dose, it is better to conduct further high quality investigation in both adults and pediatrics.
Authors and Affiliations
Abdolghader Pakniyat, Morteza Qaribi, Dorin Rahnama Hezaveh, Ali Abdolrazaghnejad
Keywords
Related Articles
- EP ID EP429989
- DOI 10.4103/2221-6189.248028
- Views 115
- Downloads 0
Intervention of Peiyuan Huayu Decoction on the neuron damage in model rats with acute subdural hematoma
Objective: To study the intervention effect of Peiyuan Huayu Decoction on the neuron damage in model rats with acute subdural hematoma (ASDH). Methods: 160 SD rats were randomly divided into four groups, and the ASDH mod...
Curative effect of minimally invasive puncture and drainage assisted with alteplase on treatment of acute intracerebral hemorrhage
Objective: To investigate the different effects on evacuation of hematoma, the severity of nerve injury, inflammatory reaction and oxidative stress response in the treatment of acute intracerebral hemorrhage by using min...
Experimental study on EPO treatment of model rats with infection-induced acute liver injury
Objective: To study the effect of EPO therapy on liver injury, inflammation, oxidative stress and cell apoptosis in model rats with infection-induced acute liver injury. Methods: SD rats were selected and randomly divide...
Effect of protective lung ventilation strategy combined with lung recruitment maneuver in patients with acute respiratory distress syndrome (ARDS)
Objective: To evaluate the efficacy and safety of protective lung ventilation strategy combined with lung recruitment maneuver (RM) in the treatment patients with acute respiratory distress syndrome (ARDS). Methods: Tota...
Gastro-protective effect of Ziziphus abyssinica root extracts in ethanol-induced acute ulcer in Wistar rats
Objective: To evaluate the gastro-protective effect of the aqueous, methanol and hexane root extracts of Ziziphus abyssinica on ethanol induced gastric ulcer in Wistar rats as models. Methods: Seventy rats were divided i...