Comparison of Treatment by IN Ketamine to IV Morphine in Acute Pain
Status:
Not yet recruiting
Trial end date:
2021-12-01
Target enrollment:
Participant gender:
Summary
Patients who present with acute traumatic injuries in the pre-hospital setting or to the
emergency department (ED) are treated with opioids, the current gold standard for severe
acute pain therapy. Treatment with opioids has many disadvantages: the need of skilled
manpower to administer the medication IV, numerous side effects- mainly cardiorespiratory
depression- which necessitates post medication administration continuous monitoring of
patients. IV administration may be difficult or impossible to provide in a number of extreme
circumstances. For these reasons, there is a constant search for alternate treatment options
for pain in acute traumatic injuries. IN ketamine has only recently been studied favorably in
our department in adults, in an open, prospective study (Shimonovich at al 2016), and
warrants further investigation in the setting of acute traumatic pain. Ketamine is a safe and
efficacious analgesic and is overall well received both by patients and physicians. Side
effects include: hallucinations and dissociation. As opposed to opioids, ketamine does not
alter patients' respiratory and hemodynamic stability giving ketamine great therapeutic
potential for pain reduction in trauma patients, pre-hospital patients, and battlefield
injuries. The study we are conducting is designed to test and analyze the safety and efficacy
of IN Ketamine compared to IV morphine in a setting of acute traumatic pain in the ED, when
both medications are administered by the protocol as is customary for treatment of pain in
the Emergency Medicine department, and will be a prospective, randomized, double blind,
controlled study.