None listed
Conditions
Brief summary
Opioids have been successfully used as analgesics in the management of acute pain in the emergency department for many years. Unfortunately, in the setting of moderate to severe pain, the large doses required to relieve the pain are associated with adverse side effects. This can range from nausea and vomiting to respiratory depression. We believe that the addition of ketamine (a dissociative agent with analgesic properties) will help to alleviate moderate to severe pain that has not responded to traditional opioid dosing. The added benefit of the use of ketamine is that it has been shown to be a safe analgesic with a limited side effect profile at the doses required to provide adequate analgesia. The primary aim of the project will be to see if patients in the emergency department who have moderate to severe pain (defined as a pain score of >5/10) despite already receiving opiate analgesia can attain significantly better pain relief with the addition of ketamine rather than further doses of opiates.
Interventions
The effectiveness of intravenous ketamine in relieving moderate to severe acute pain in patients that have already received opiate analgesia by comparing verbal numeric rating scale pain scores at 30 and 60 minutes with controls. The ketamine will be given as 10mg aliquots every 5 minutes to a maximum of 40mg as guided by the patient's request for analgesia. The patient's pain scores and a record of whether any aliquots were given and at what times will be recorded using a standardised data col
The effectiveness of intravenous ketamine in relieving moderate to severe acute pain in patients that have already received opiate analgesia by comparing verbal numeric rating scale pain scores at 30 and 60 minutes with controls. The ketamine will be given as 10mg aliquots every 5 minutes to a maximum of 40mg as guided by the patient's request for analgesia. The patient's pain scores and a record of whether any aliquots were given and at what times will be recorded using a standardised data collection tool.
Sponsors
Bundaberg Base Hospital
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Subject, Caregiver, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to 95 Years
Healthy volunteers
No
Inclusion criteria
Patients reporting acute onset of pain of any cause except cardiac origin but including cases where the cause is unknown. A verbal numeric rating scale pain score of greater than or equal to 5 after having received a total intravenous dose of 7.5mg morphine, 100mcg fentanyl or other equipotent opiate.
Exclusion criteria
Patients whose primary language is other than English Women who are pregnant Patients aged <18 years Patients with intellectual or mental impairment A patient in whom we are unable to gain venous access Patients with known chronic kidney disease stage 4 or above Acute severe respiratory distress Presenting with presumed cardiac diagnosis A documented allergy to morphine or ketamine
Outcome results
None listed