Low Dose Ketamine (LDK) Versus Morphine for Acute Pain Control in the Emergency Department

• Status: Completed
• Trial end date: 2013-06-01
• Target enrollment: 0
• Participant gender: All

Summary

The purpose of this study is to compare the safety and effectiveness of intravenous low dose ketamine (LDK) to the industry standard of morphine (MOR) in regards to controlling acute pain in the emergency department.

Both LDK and morphine have side effects. The amount and character of these side effects will be compared. Additionally, the degree of sedation or agitation will be specifically measured. The aim of this current study is to make this comparison and shift the evidence for LDK use from the anecdotal to the scientific.

• Phase: Phase 4
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Brooke Army Medical Center
• Collaborator: U.S. Air Force Office of the Surgeon General
• Treatments: Ketamine; Morphine

Criteria

Inclusion Criteria:

• Patients age 18-59 who present to the Brooke Army Medical Center Emergency Department with acute (less than 10 days) abdominal pain, flank/lumbar back pain and or/pain to the extremities, and of sufficient severity in the judgement of the ED treating physician or PA to warrant use of intravenous opioids

Exclusion Criteria:

• Poor vital sign stability hypoxia: Sats<95% hypotension: SBP<90 hypertension: SBP>180 heart rate: <50 or >120 respiratory rate: <10 or >30

• Altered mental status or intoxication

• Patient is unwilling to participate or provide informed consent

• History of chronic pain or pain syndrome with concurrent opioid medication use

• fibromyalgia

• Patient has received opioids and/or tramadol in the past 4 hours

• Prescription pain medication use (to exclude muscle relaxants, acetaminophen or NSAIDs including toradol) in the past 4 hours

• Allergy to morphine or ketamine

• Sole provider status

• Adverse reaction to morphine or ketamine in the past

• Patients, who in the opinion of the triage nurse, require immediate analgesic relief

• Patient is female of child-bearing age and unable to provide urine or serum for HCG analysis in triage

• Pregnancy or breast feeding

• Presence of oxygen dependent pulmonary disease, liver cirrhosis or Renal disease requiring dialysis. (as assessed by electronic chart review)

• Presence of Ischemic heart disease, heart failure or unstable dysrhythmias (as assessed by electronic chart review)

• Presence of intracranial mass or vascular lesion.

• Presence of psychosis or hallucinations

• Weight greater than 115kg or less than 45 kg

• History of acute ocular/head trauma

• History of increased intracranial pressure/hypertensive hydrocephalus

• Non-English speaking patients