Low Dose Ketamine Used for Acute Pain Management in the Emergency Department

Abstract

The use of opioid analgesics has created an opioid addiction epidemic in the United States and around the world. One of the main responsibilities of the emergency department is to address acute pain. In this paper we examine the use of low dose ketamine as a safe substitute for opioid analgesics. Types of pain are identified using prior established taxonomy, followed by discussing types of management and treatments. The opioid epidemic and its societal implications are considered. We also examine the side effects of ketamine and the use of ketamine as an adjunct to analgesics used for pain control. Recommendations and considerations for the use of ketamine are suggested, and a low dose ketamine administration sample hospital policy is reviewed.

Year 2020 in review - Perioperative pain therapy

“…Autoři doporučují použití ketaminu jako analgetika zejména u pacientů, kde by použití opioidů mohlo být nebezpečné nebo jejich účinky nepředvídatelné: pacienti v ebrietě, hypotenzi, se substituční léčbou závislosti na opioidech a s chronickým používáním opioidů. Přehledný článek o praktickém využití ketaminu na urgentních příjmech vydali i Kestenian et al [9] rovněž v tomto roce a ketamin je zmiňován i v recentních doporučeních pro léčbu akutní bolesti v přednemocniční péči vydané Evropskou společností urgentní medicíny (EUSEM) [10]. Ketamin je všestranně používaný nejen v akutní medicíně, ale i u pacientů na jednotkách intenzivní péče (JIP).…”

Low-dose ketamine as an analgesic agent in the emergency department: Efficacy and safety

“…[ 2 ] With the introduction of newer anesthetics with more limited side effects, this drug that was derived from phencyclidine and cyclohexylamine rapidly lost its popularity. [ 3 4 ] However, ketamine has a unique ability to induce catalepsy, and while providing analgesia, sedation, and forgetfulness at the same time, it can also maintain airway reflexes and hemodynamic stability. [ 4 ] Ketamine, which is used intramuscularly, intravenously, intranasally, and rectally,[ 5 ] is an anesthetic drug that also causes severe analgesia, stimulates the sympathetic nervous system, and increases blood pressure and heart rate[ 6 ]: It also increases breathing rate and can dilate the bronchi.…”