Study on Ketamine Doses for Pain Management

All three different doses of ketamine given through a breath-actuated nebulizer for moderate to severe pain are equally efficient, suggests a study published in the Annals of Emergency Medicine.

A group of researchers from the U.S.A. performed a study to assess and compare the analgesic efficacies and adverse effects of ketamine administered through a breath-actuated nebulizer at 3 different dosing regimens for patients present in the emergency department presenting with acute and chronic painful conditions.

The researchers conducted a prospective, randomized, double-blinded trial comparing 3 doses of nebulized ketamine: 0.75 mg/kg, 1 mg/kg, and 1.5 mg/kg respectively administered through breath-actuated nebulizer in adult emergency department patients aged 18 years and older with moderate to severe acute and chronic pain. In total, they enrolled 120 patients with 40 in each group.

The primary outcome included the difference in pain scores on an 11-point numeric rating scale between all 3 groups at 30 minutes. Secondary outcomes included the need for rescue analgesia (additional doses of nebulized ketamine or intravenous morphine) and adverse events in each group at 30 and 60 minutes.

Results of the Study

• The difference in mean pain scores at 30 minutes between the 0.75 mg/kg and 1 mg/kg groups was 0.25; between the 1 mg/kg and 1.5 mg/kg groups was −0.225; and between the 0.75 mg/kg and 1.5 mg/kg groups was 0.025.
• No clinically concerning changes in vital signs occurred.
• No serious adverse events occurred in any of the groups.

Thus, the researchers concluded that there is no difference between all 3 doses of ketamine administered through breath-actuated nebulizer for short-term treatment of moderate to severe pain in the emergency department.

Reference

"Comparison of Nebulized Ketamine at Three Different Dosing Regimens for Treating Painful Conditions in the Emergency Department: A Prospective, Randomized, Double-Blind Clinical Trial" by Dove D published in the Annals of Emergency Medicine.

DOI: https://doi.org/10.1016/j.annemergmed.2021.04.031