Dr. Smith is chief resident at the Sinai-Grace Hospital emergency medicine residency program at Wayne State University School of Medicine in Detroit.
Explore This Issue
ACEP Now: Vol 36 – No 08 – August 2017
Dr. Messman is the associate program director of the Sinai-Grace Hospital emergency medicine residency program and assistant professor at Wayne State University School of Medicine.
Dr. Wilburn is faculty in the Sinai-Grace Hospital emergency medicine residency program and assistant professor at Wayne State University School of Medicine.
References
- Black IH, McManus J. Pain management in current combat operations. Prehosp Emerg Care. 2008;13(2):223-227.
- Beaudoin FL, Lin C, Guan W, et al. Low-dose ketamine improves pain relief in patients receiving intravenous opioids for acute pain in the emergency department: results of a randomized, double-blind, clinical trial. Acad Emerg Med. 2014;21(11):1193-1202.
- Ahern TL, Herring AA, Miller S, et al. Low-dose ketamine infusion for emergency department patients with severe pain. Pain Med. 2015;16(7):1402-1409.
- Miller JP, Schauer SG, Ganem VJ, et al. Low-dose ketamine vs morphine for acute pain in the ED: a randomized controlled trial. Am J Emerg Med. 2015;33(3):402-408.
- Richards JR, Rockford RE. Low-dose ketamine analgesia: patient and physician experience in the ED. Am J Emerg Med. 2013;31(2):390-394.
- Ahern TL, Herring AA, Anderson ES, et al. The first 500: initial experience with widespread use of low-dose ketamine for acute pain management in the ED. Am J Emerg Med. 2015;33(2):197-201.
- Cohen L, Athaide V, Wickham ME, et al. The effect of ketamine on intracranial and cerebral perfusion pressure and health outcomes: a systematic review. Ann Emerg Med. 2015;65(1):43-51.e2.
- Green SM, Clark R, Hostetler MA, et al. Inadvertent ketamine overdose in children: clinical manifestations and outcome. Ann Emerg Med. 1999;34(4 Pt 1):492-497.
- Motov S, Mai M, Pushkar I, et al. A prospective randomized, double-dummy trial comparing intravenous push dose of low dose ketamine to short infusion of low dose ketamine for treatment of moderate to severe pain in the emergency department [published online ahead of print March 3, 2017]. Am J Emerg Med.
Pages: 1 2 3 | Single Page
5 Responses to “Low-Dose Ketamine Emerges as Effective Opioid Alternative”
August 21, 2017
Dr. Chuck SwansonI used to live to use it. Would still use it, but in Mississippi ER nurses are not not allowed to monitor patients that have been given moderate sedation. New head of Nursing Board is a NA and made ruling. I work in 2 smaller ERs and it has hampered our ability to care for patients. Can give Versed, a BZD and Fentanyl. Sucks
September 9, 2017
Gabe WilsonChuck,
This same issue crops up all over. The key is, this is not moderate sedation. This is analgesia. In the past Ketamine was only used for sedation so the thought process is locked into using at such.
Change the thinking.
Share the evidence.
In the end, low dose ketamine is much safer the hydromorphone or many of the alternatives.
September 5, 2017
Laura QuintThe bigger issue with ketamine as an analgesic is it’s use outside of the ED – it is all very well if you can discharge home after using but if being admitted you risk misaligned expectations from the patient.
Many places only approve low dose ketamine in the ED, ICU and occasionally the OR/PACU.
What about everyone else?
January 6, 2020
Arnold MillerAny body have experience with using LDK for migraines for heavily pretreated patients?
January 15, 2021
Michelle CostelloSounds quite interesting
Many pain relievets
Are hard on kidneys
And often not effective
Long term
Very interesting