1.Patients aged 65 and older, who presented to the ED with the chief complaint of musculoskeletal pain within 7 days. 2.Pain score of 5 or more on a 11-point numeric rating scale [0 (no pain) to 10 (most severe pain)]. ketamine Nebulizer, older adults, pain management
Conditions
Interventions
Ketamine group: ketamine 0.75 mg/kg with NSS up to 5 ml via nebulizer,Morphine group:0.1 mg/kg for intravenous route and NSS up to 10 ml.
Active Comparator Drug,Active Comparator Drug
Nebulized ketamine,Intravenous morphine
Sponsors
NAVAMINDRADHIRAJ UNIVERSITY RESEARCH FUND
Eligibility
Sex/Gender
All
Age
65 Years to No maximum
Inclusion criteria
Inclusion criteria: 1.Patients aged 65 and older, who presented to the ED with the chief complaint of musculoskeletal pain within 7 days. 2.Pain score of 5 or more on a 11-point numeric rating scale [0 (no pain) to 10 (most severe pain)].
Exclusion criteria
Exclusion criteria: 1. Patients who had hemodynamic instability which were defined as systolic blood pressure < 90 or > 180 mmHg, heart rate < 50 or > 150 beats/min , respiratory rate < 10 or > 30 breaths /min. 2. Patients with comorbidities of coronary artery disease or congestive heart failure, psychological disorder or severe chronic obstructive pulmonary disease. 3. Patient with chronic pain 4. History of traumatic brain or eye injury. 5. History of seizure or intracranial hypertension. 6. History of morphine or ketamine allergy. 7. History of opioid used within 8 hours (e.g. tramadol, fentanyl , morphine, codeine, pethidine, methadone) or unknown drug used.) 8. History of alcohol or drug abuse. 9. Actual body weight < 40 kilogram (kg) or > 115 kg. 10. Creatinine clearance < 50 ml/min. 11. Hepatic insufficiency. 12. Patients who needed immediate surgical intervention. 13. Patients with difficulty to communication (e.g. altered mental status, severe dementia (define by 6-items cognitive screening > 12), language barrier).
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| reduction of pain scores on a 11-point numeric rating scale between nebulized ketamine and intravenous morphine at baseline and 15, 30, 60, 90, and 120 minutes. at baseline and 15, 30, 60, 90, and 120 minutes. a 11-point numeric rating scale | — |
Secondary
| Measure | Time frame |
|---|---|
| incidence of adverse events and the rate of rescue therapy. at baseline and 15, 30, 60, 90, and 120 minutes. anaphylaxis, cardiac arrest, intractable hypotension, hypersecretion or laryngospasm, Nausea Vomiting, Respiratory depression | — |
Countries
Thailand
Contacts
Public Contactsirasa kampan
Vajira hospital
Outcome results
None listed