Efficacy and Tolerability of Oral Compared with Sublingual Ketamine Lozenges as Rescue Analgesics in Adults for Acute Pain: The OSKet Trial

Chong, Chui; Schug, Stephan A.

doi:10.1007/s40261-021-01066-x

Cited by 2 publications

(7 citation statements)

References 28 publications

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“…Ketamine has been used for sedating a patient and treating pain by SJWA paramedics 10 . Ketamine wafers (Wafermine™) for sublingual administration, which avoid the hepatic first‐pass effect, have been used by medical practitioners for a number of years, and their safety and effectiveness have been reported 11,12 . The advantage of the sublingual over the oral administration is the faster onset of effect 12 .…”

Section: Methodsmentioning

confidence: 99%

“…10 Ketamine wafers (Wafermine™) for sublingual administration, which avoid the hepatic first-pass effect, have been used by medical practitioners for a number of years, and their safety and effectiveness have been reported. 11,12 The advantage of the sublingual over the oral administration is the faster onset of effect. 12 Ketamine wafers (Wafermine™) are currently available to prescribers under the exemption of Schedule 5A of the Australian Therapeutic Goods Regulations.…”

Section: Ketamine Wafermentioning

confidence: 99%

“…11,12 The advantage of the sublingual over the oral administration is the faster onset of effect. 12 Ketamine wafers (Wafermine™) are currently available to prescribers under the exemption of Schedule 5A of the Australian Therapeutic Goods Regulations. SJWA has required Schedule 8 compliance requirements as per the Medicines and Poisons Regulations 2016, WA, inclusive of Structured Administration and Supply Arrangements that allow ambulance clinicians to administer medications to patients as per our approved clinical practice guidelines.…”

Section: Ketamine Wafermentioning

confidence: 99%

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Use of ketamine wafer for pain management by volunteer emergency medical technicians in rural Western Australia

Tohira

Brink

Davids

et al. 2023

Emerg Medicine Australasia

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ObjectiveTo describe the use of sublingual ketamine wafers administered by volunteer emergency medical technicians (EMTs) for pain management to patients in rural Western Australia (WA).MethodsThis retrospective cohort study included patients older than 12 years who were attended by volunteer EMTs in Esperance, Lancelin and Kalbarri, WA and received analgesic medications from 2018 to 2021. Patients who received ketamine wafers with/without other analgesics were compared to (i) patients who received only oral paracetamol and (ii) patients who received inhalational methoxyflurane without ketamine wafers with/without paracetamol.ResultsThe present study included 826 patients, among whom 149 patients received ketamine wafer with/without other analgesics, 82 paracetamol only and 595 methoxyflurane with/without paracetamol. Patients who received ketamine wafers were younger (median age 49 years vs 54 years for the paracetamol group vs 58 years for the methoxyflurane group), required a longer median transport interval (56 min vs 20 min vs 8 min), trauma‐related (73% vs 35% vs 54%), and presented higher median initial pain score (9 vs 3 vs 8 out of 10) than those who received paracetamol and those who received methoxyflurane, respectively. Eight in the ketamine wafers group (5.4%) had a record of nausea/vomiting after the administration of ketamine wafers.ConclusionsSublingual ketamine wafer was administered by volunteer EMTs without any evidence of major adverse events in rural WA and deemed useful as an additional pain management option when long transport to hospital was needed. No other symptoms that may be associated with the use of ketamine were recorded.

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Section: Methodsmentioning

confidence: 99%

Section: Ketamine Wafermentioning

confidence: 99%

Section: Ketamine Wafermentioning

confidence: 99%

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Use of ketamine wafer for pain management by volunteer emergency medical technicians in rural Western Australia

Tohira

Brink

Davids

et al. 2023

Emerg Medicine Australasia

Self Cite

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“…As intravenous ketamine administration can be considered invasive, other routes of ketamine administration have been proposed and studied, such as oral, topical, nebulised and intranasal ketamine. Of importance is the difference in bioavailability of the different routes of administration (bioavailability percentage): topical < 5%; oral 10–20%; sublingual 24–30%; intranasal 25–50%; nebulised 40–70% [ 135 , 140 , 141 ].…”

Section: Peripheral and Central Sensitisationmentioning

confidence: 99%

“…The incidence of psychotomimetic adverse effects was significantly higher in the 0.4 mg/kg dose group [ 160 ]. Furthermore, there could potentially be a role for nebulised and sublingual S-ketamine in pain management [ 140 , 141 ]; however, evidence for these routes of administration is lacking in CRPS.…”

Section: Peripheral and Central Sensitisationmentioning

confidence: 99%

From a Symptom-Based to a Mechanism-Based Pharmacotherapeutic Treatment in Complex Regional Pain Syndrome

Mangnus

Bharwani

Dirckx

et al. 2022

Drugs

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Complex regional pain syndrome (CRPS) is a debilitating painful condition of a distal extremity that can develop after tissue damage. CRPS is thought to be a multimechanism syndrome and ideally the most prominent mechanism(s) should be targeted by drugs in an individually tailored manner. This review gives an overview of the action and evidence of current and future pharmacotherapeutic options for CRPS. The available options are grouped in four categories by their therapeutic actions on the CRPS mechanisms, i.e. inflammation, central sensitisation, vasomotor disturbances and motor disturbances. More knowledge about the underlying mechanisms of CRPS helps to specifically target important CRPS mechanisms. In the future, objective biomarkers could potentially aid in selecting appropriate mechanism-based drugs in order to increase the effectiveness of CRPS treatment. Using this approach, current and future pharmacotherapeutic options for CRPS should be studied in multicentre trials to prove their efficacy. The ultimate goal is to shift the symptom-based selection of therapy into a mechanism-based selection of therapy in CRPS.

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Efficacy and Tolerability of Oral Compared with Sublingual Ketamine Lozenges as Rescue Analgesics in Adults for Acute Pain: The OSKet Trial

Cited by 2 publications

References 28 publications

Use of ketamine wafer for pain management by volunteer emergency medical technicians in rural Western Australia

Use of ketamine wafer for pain management by volunteer emergency medical technicians in rural Western Australia

From a Symptom-Based to a Mechanism-Based Pharmacotherapeutic Treatment in Complex Regional Pain Syndrome

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