The Effect of Low Dose Ketamine on the Need for Morphine in Patients with Multiple Trauma in Emergency Department
Journal Title: Eurasian Journal of Emergency Medicine - Year 2020, Vol 19, Issue 4
Abstract
Aim: There are a few analgesic drugs (morphine, ketamine, Paracetamol, etc.) used for pain control in injury patients. Previous studies showed that low-dose ketamine (doses less than 1 mg/kg) promptly and satisfactorily resolved pain. This study aimed to compare the analgesic effects of morphine with placebo (MP group) to that of a combination of morphine with ketamine (MK group) for patients with multiple trauma (MT) in the emergency department (ED). Materials and Methods: This randomized, controlled, double-blinded clinical trial was conducted in the ED of two university teaching hospitals. Seventy multiple trauma patients aged between 16 and 50 years with a severe acute pain defined as a visual analog scale (VAS) score of at least 70 (between 0 and 100) were enrolled. Patients were randomly assigned to receive intravenous morphine (0.1 mg/kg) with placebo or morphine (0.05 mg/kg) with low-dose ketamine (0.3 mg/kg) for pain control. The pain intensity was evaluated before and 10th, 20th, 30th, and 60th minutes after the intervention, and probable side effects were recorded. Efficient analgesia was defined as a VAS score not exceeding 30. If the VAS score was still above 30, additional morphine (3 mg) was administered for both groups. The primary outcome was the VAS score at 30 minutes. Results: Seventy patients were enrolled in this study. There was no difference between the groups in terms of demographic characteristics or vital signs and baseline pain scores. The pain intensity decreased significantly in both groups 30 minutes after the intervention. However, there was no significant difference between the mean VAS scores of the two groups before and after the intervention. Morphine consumption was significantly lower in the MK group versus the MP group (9.3±2.2 vs 6.1±2.7, p=0.01). In addition, there was no significant difference between the two groups in terms of complications (p>0.05). Conclusion: Low-dose ketamine in combination with morphine significantly reduced the need for an additional dose of morphine without increasing the complication rate related to morphine alone.
Authors and Affiliations
Farhad Heydari, Reza Azarian, Babak Masoumi, Alireza Abootalebi Ghahnavieh
Keywords
Related Articles
- EP ID EP689919
- DOI 10.4274/eajem.galenos.2020.67689
- Views 191
- Downloads 0
Comparison of the McGrath MAC EMS Videolaryngoscope with a Conventional Laryngoscope for Standard and Difficult Airway Intubation: A Randomized, Cross-over, Simulation Trial
Aim: Tracheal intubation is challenging in emergency medicine, especially in pre-hospital settings, owing to problems connected with patients, intubator, and the environment. The study aimed to compare the effectiveness...
Assessment of Suicidal Cases Among Emergency Department Applicants Kütahya Evliya Çelebi Training and Research Hospital Experience
Aim: Our work is aim at sharing our experiences in suicide cases which constitute a significant part of the psychiatric emergency cases. We hope to draw attention to the factors involved in suicide attempts. This is inte...
Characteristics of Patients with Tramadol Use or Abuse: A Systematic Review and Meta-Analysis
Recently, an increasing number of studies have reported an association between the incidence of seizures and the use or abuse of tramadol. The aim of this study was to review articles involving patients with tramadol-ind...
Investigation of Aspiration Pneumonia and Respiratory Tract Complications in Cases Presenting to the Emergency Service with Intoxication: A Prospective Study
Aim: In this study, we aimed to investigate the frequency of aspiration pneumonia (AP) and factors affecting AP development in patients presenting to the emergency department with intoxication. Materials and Methods: Th...
The Value of Cardiotrophin-1 in the Diagnosis, Severity, and Prognosis of Pulmonary Embolism
Aim: Pulmonary embolism (PE) is a life-threatening condition that requires early diagnosis and treatment. There is still a need for precise and non-invasive biomarkers that can be used to diagnose PE. This study aimed t...