Lower Ketamine Dose Can Provide Pain Relief for Acute Pain in ER

PainRelief.com Interview with:
Shannon Lovett, MD, FACEP
Associate Professor
Associate Medical Director, ED Clinical Operations
Department of Emergency Medicine
Stritch School of Medicine

Dr. Lovett

PainRelief.com:  What is the background for this study?  What types of pain were treated?

Response: The opioid crisis has led emergency medicine providers to utilize other medications to treat pain, including ketamine. Prior to our study, there was a range of recommended ketamine doses in the treatment of pain, and the most frequently studied dose demonstrating analgesic efficacy was 0.3 mg/kg. We challenged that dose by comparing a lower dose, 0.15 mg/kg, to 0.3 mg/kg of IV ketamine for acute moderate to severe pain in the emergency department. We treated acute (onset < 7 days) abdominal, back, flank, musculoskeletal, and headache pain. 

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Nebulized Ketamine May Offer Pain Relief to Emergency Room Patients

PainRelief.com Interview with:

Jefferson Drapkin BS
Research Associate
Maimonides Medical Center
Department of Emergency Medicine
Brooklyn, New York

PainRelief.com:  What is the background for this study?  What are the main findings?

Response: Nebulized administration of ketamine has been studied in the areas of palliative care, therapy for asthma, and acute postoperative management of sore throat. To our knowledge, there is no literature regarding analgesic efficacy and safety of nebulized ketamine’s role in managing acute painful conditions in the emergency department (ED).

As all five patients had a decrease in pain from baseline to 120 min, this case series demonstrates that the inhalation route of ketamine delivery via breath-actuated nebulizer may have utility for managing pain in the ED.