Comparison of the analgesic dose of intravenous ketamine versus ketorolac in patients with chest trauma: A randomized double-blind clinical trial.

IF 3.4 3区医学 Q1 EMERGENCY MEDICINE

Academic Emergency Medicine Pub Date : 2024-12-31 DOI:10.1111/acem.15050

Hossein Zabihi Mahmoodabadi, Zeynab Seyed Javadein, Fatemeh Moosaie, Ali Faegh, Maryam Bahreini

{"title":"Comparison of the analgesic dose of intravenous ketamine versus ketorolac in patients with chest trauma: A randomized double-blind clinical trial.","authors":"Hossein Zabihi Mahmoodabadi, Zeynab Seyed Javadein, Fatemeh Moosaie, Ali Faegh, Maryam Bahreini","doi":"10.1111/acem.15050","DOIUrl":null,"url":null,"abstract":"Background: Pain management is a critical part of treatment in patients with chest trauma. Opioids and nonsteroidal anti-inflammatory drugs have been the most commonly used medications. However, their side effects have drawn attention to other medications. In this study, we aimed to assess the effect of the analgesic dose of ketamine in patients with chest trauma in comparison to ketorolac.Methods: A randomized, double-blind clinical trial was conducted in three hospitals. Patients were randomly allocated into two groups: 45 in the ketorolac group (30 mg intravenous [IV] and 45 in the ketamine group [0.25 mg/kg IV]). Pain was rated via numeric rating scale (NRS) before and 30 and 60 min after the drug injection. Morphine was used as the rescue medication. Furthermore, the adverse events of the two study regimens were rated.Results: Pain was more significantly relieved in the ketamine group, 30 and 60 min after drug administration, compared to ketorolac (median [IQR] 95% CI 30-min NRS 3.0 [1.0] 2.8-3.5 vs. 5.0 [4.5] 4.2-5.8, p = 0.006; and 60-min NRS 3.0 [2.0] 2.7-3.7 vs. 5.6 [1.7] 4.7-6.4, p < 0.001), respectively. Among patients with a chest tube, pain was more significantly controlled in the ketamine group (p < 0.001). Also, patients in the ketamine group needed less rescue pain medications compared to the ketorolac group although they reported more frequent nausea.Conclusion: Ketamine can be an effective analgesic in patients with chest trauma in acute settings with or without rib fracture.","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.4000,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Academic Emergency Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/acem.15050","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"EMERGENCY MEDICINE","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Pain management is a critical part of treatment in patients with chest trauma. Opioids and nonsteroidal anti-inflammatory drugs have been the most commonly used medications. However, their side effects have drawn attention to other medications. In this study, we aimed to assess the effect of the analgesic dose of ketamine in patients with chest trauma in comparison to ketorolac.

Methods: A randomized, double-blind clinical trial was conducted in three hospitals. Patients were randomly allocated into two groups: 45 in the ketorolac group (30 mg intravenous [IV] and 45 in the ketamine group [0.25 mg/kg IV]). Pain was rated via numeric rating scale (NRS) before and 30 and 60 min after the drug injection. Morphine was used as the rescue medication. Furthermore, the adverse events of the two study regimens were rated.

Results: Pain was more significantly relieved in the ketamine group, 30 and 60 min after drug administration, compared to ketorolac (median [IQR] 95% CI 30-min NRS 3.0 [1.0] 2.8-3.5 vs. 5.0 [4.5] 4.2-5.8, p = 0.006; and 60-min NRS 3.0 [2.0] 2.7-3.7 vs. 5.6 [1.7] 4.7-6.4, p < 0.001), respectively. Among patients with a chest tube, pain was more significantly controlled in the ketamine group (p < 0.001). Also, patients in the ketamine group needed less rescue pain medications compared to the ketorolac group although they reported more frequent nausea.

Conclusion: Ketamine can be an effective analgesic in patients with chest trauma in acute settings with or without rib fracture.

查看原文本刊更多论文

胸外伤患者静脉注射氯胺酮与酮罗拉酸镇痛剂量的比较：一项随机双盲临床试验。

背景：疼痛管理是胸部创伤患者治疗的关键部分。阿片类药物和非甾体类抗炎药是最常用的药物。然而，它们的副作用引起了人们对其他药物的关注。在这项研究中，我们旨在评估氯胺酮镇痛剂量对胸部创伤患者的影响，并与酮罗拉酸进行比较。方法：在三家医院进行随机、双盲临床试验。患者随机分为两组：酮咯酸组45例（静脉注射30 mg [IV]），氯胺酮组45例（静脉注射0.25 mg/kg]）。采用数值评定量表（NRS）对注射前、注射后30、60 min的疼痛进行评定。吗啡作为抢救药物。此外，对两种研究方案的不良事件进行了评估。结果：氯胺酮组在给药后30和60 min疼痛的缓解较酮罗拉酸组更为显著(中位[IQR] 95% CI 30-min NRS 3.0 [1.0] 2.8-3.5 vs. 5.0 [4.5] 4.2-5.8, p = 0.006；60 min NRS 3.0 [2.0] 2.7 ~ 3.7 vs. 5.6 [1.7] 4.7 ~ 6.4， p结论：氯胺酮可作为急性胸外伤伴或不伴肋骨骨折患者的有效镇痛药。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Academic Emergency Medicine 医学-急救医学

CiteScore

7.60

自引率

6.80%

发文量

207

审稿时长

3-8 weeks

期刊介绍： Academic Emergency Medicine (AEM) is the official monthly publication of the Society for Academic Emergency Medicine (SAEM) and publishes information relevant to the practice, educational advancements, and investigation of emergency medicine. It is the second-largest peer-reviewed scientific journal in the specialty of emergency medicine. The goal of AEM is to advance the science, education, and clinical practice of emergency medicine, to serve as a voice for the academic emergency medicine community, and to promote SAEM''s goals and objectives. Members and non-members worldwide depend on this journal for translational medicine relevant to emergency medicine, as well as for clinical news, case studies and more. Each issue contains information relevant to the research, educational advancements, and practice in emergency medicine. Subject matter is diverse, including preclinical studies, clinical topics, health policy, and educational methods. The research of SAEM members contributes significantly to the scientific content and development of the journal.