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Khedija Zaouche, Mohamed Kilani, Ramla Baccouche, Radhia Boubaker, Hamida Maghraoui

La Tunisie medicale November 5, 2024 DOI: 10.62438/tunismed.v102i11.4574 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Randomized controlled trial Peer reviewed
Sample size 120
Population Adults over 18 years old with severe pain (NRS ≥6) in the emergency department
Interventions Morphine Ketamine
Dose 10 mg morphine titration; 30 mg ketamine bolus
Duration 10 minutes
Topics Ketamine
Keywords Analgesia Emergencies Opioids Pain management Emergency medicine Analgesics Ketamine therapy Opioid alternatives
Citations 1
Key findings Low-dose ketamine is non-inferior to morphine for rapid analgesia in severe pain, though it causes more adverse effects.

Abstract

Severe pain is a therapeutic emergency that can be life-threatening by its location, its repercussions or the misdiagnosis it can cause. To investigate the efficacy of analgesia by morphine versus that by low-dose ketamine in severe pain in emergency department. We conducted a randomized open study. We included patients over 18 years-old who consulted for severe pain defined by numeric rating scale (NRS) ≥6. Patients of M group received a titration of 10 mg morphine while those of LDK group, received a bolus of 30 mg of ketamine. The primary endpoint was obtaining a NRS of less than 4 within 10 minutes. We included 120 patients, 66 in the M group and 54 in the LDK group. The mean baseline NRS was 8.8 ± 1.3 in the M group and 8.6 ± 1.4 in the LDK group (p₌ 0.7). At 10 minutes, the same number of patients in both groups achieved a NRS less than 4 (p = 0.09). However, the mean NRS was significantly lower in the LDK group (p = 0.008). More adverse effects were noted in the LDK group (p <10-3). Low-dose ketamine appears to be non-inferior to morphine in achieving effective analgesia for severe pain in the emergency department.

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