Sub-dissociative-dose intranasal ketamine for moderate to severe pain in adult emergency department patients
Background: There are currently no studies assessing effectiveness of sub-dissociative intranasal (IN) ketamine as the initial analgesic for adult patients in the ED. Objective: The study aims to examine the effectiveness of sub-dissociative IN ketamine as a primary analgesic agent for adult patient...
| Main Authors: | , , , , |
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| Format: | Journal Article |
| Published: |
Blackwell Publishing
2014
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| Online Access: | http://hdl.handle.net/20.500.11937/41037 |
| _version_ | 1848756033674018816 |
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| author | Yeaman, F. Meek, R. Egerton-Warburton, Diana Rosengarten, P. Graudins, A. |
| author_facet | Yeaman, F. Meek, R. Egerton-Warburton, Diana Rosengarten, P. Graudins, A. |
| author_sort | Yeaman, F. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Background: There are currently no studies assessing effectiveness of sub-dissociative intranasal (IN) ketamine as the initial analgesic for adult patients in the ED. Objective: The study aims to examine the effectiveness of sub-dissociative IN ketamine as a primary analgesic agent for adult patients in the ED. Method: This is a prospective, observational study of adult ED patients presenting with severe pain (=6 on 11-point scale at triage). IN ketamine dose was 0.7mg/kg, with secondary dose of 0.5mg/kg at 15min if pain did not improve. After 6 months, initial dose was increased to 1.0mg/kg with the same optional secondary dose. Primary outcomes: The primary outcomes are change in VAS rating at 30min; percentage of patients reporting clinically significant reduction in VAS (=20mm) at 30min; dose resulting in clinically significant pain reduction. Results: Of the 72 patients available for analysis, median age was 34.5 years and 64% were men. Median initial VAS rating was 76mm (interquartile range [IQR]: 65-82). Median total dose of IN ketamine for all patients was 0.98mg/kg (IQR: 0.75-1.15, range: 0.59-1.57). Median reduction in VAS rating at 30min was 24mm (IQR: 2-45). Forty (56%, 95% CI: 44.0-66.7) reported VAS reduction =20mm, these patients having had a total median ketamine dose of 0.94mg/kg (IQR: 0.72-1.04). Conclusion: IN ketamine, at a dose of about 1mg/kg, was an effective analgesic agent in 56% of study patients. The place of IN ketamine in analgesic guidelines for adults requires further investigation. |
| first_indexed | 2025-11-14T09:05:46Z |
| format | Journal Article |
| id | curtin-20.500.11937-41037 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T09:05:46Z |
| publishDate | 2014 |
| publisher | Blackwell Publishing |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-410372017-09-13T14:28:47Z Sub-dissociative-dose intranasal ketamine for moderate to severe pain in adult emergency department patients Yeaman, F. Meek, R. Egerton-Warburton, Diana Rosengarten, P. Graudins, A. Background: There are currently no studies assessing effectiveness of sub-dissociative intranasal (IN) ketamine as the initial analgesic for adult patients in the ED. Objective: The study aims to examine the effectiveness of sub-dissociative IN ketamine as a primary analgesic agent for adult patients in the ED. Method: This is a prospective, observational study of adult ED patients presenting with severe pain (=6 on 11-point scale at triage). IN ketamine dose was 0.7mg/kg, with secondary dose of 0.5mg/kg at 15min if pain did not improve. After 6 months, initial dose was increased to 1.0mg/kg with the same optional secondary dose. Primary outcomes: The primary outcomes are change in VAS rating at 30min; percentage of patients reporting clinically significant reduction in VAS (=20mm) at 30min; dose resulting in clinically significant pain reduction. Results: Of the 72 patients available for analysis, median age was 34.5 years and 64% were men. Median initial VAS rating was 76mm (interquartile range [IQR]: 65-82). Median total dose of IN ketamine for all patients was 0.98mg/kg (IQR: 0.75-1.15, range: 0.59-1.57). Median reduction in VAS rating at 30min was 24mm (IQR: 2-45). Forty (56%, 95% CI: 44.0-66.7) reported VAS reduction =20mm, these patients having had a total median ketamine dose of 0.94mg/kg (IQR: 0.72-1.04). Conclusion: IN ketamine, at a dose of about 1mg/kg, was an effective analgesic agent in 56% of study patients. The place of IN ketamine in analgesic guidelines for adults requires further investigation. 2014 Journal Article http://hdl.handle.net/20.500.11937/41037 10.1111/1742-6723.12173 Blackwell Publishing unknown |
| spellingShingle | Yeaman, F. Meek, R. Egerton-Warburton, Diana Rosengarten, P. Graudins, A. Sub-dissociative-dose intranasal ketamine for moderate to severe pain in adult emergency department patients |
| title | Sub-dissociative-dose intranasal ketamine for moderate to severe pain in adult emergency department patients |
| title_full | Sub-dissociative-dose intranasal ketamine for moderate to severe pain in adult emergency department patients |
| title_fullStr | Sub-dissociative-dose intranasal ketamine for moderate to severe pain in adult emergency department patients |
| title_full_unstemmed | Sub-dissociative-dose intranasal ketamine for moderate to severe pain in adult emergency department patients |
| title_short | Sub-dissociative-dose intranasal ketamine for moderate to severe pain in adult emergency department patients |
| title_sort | sub-dissociative-dose intranasal ketamine for moderate to severe pain in adult emergency department patients |
| url | http://hdl.handle.net/20.500.11937/41037 |