{"title":"急诊科急性剧烈疼痛：吗啡还是小剂量氯胺酮？","authors":"Khedija Zaouche, Mohamed Kilani, Ramla Baccouche, Radhia Boubaker, Hamida Maghraoui","doi":"10.62438/tunismed.v102i11.4574","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Severe pain is a therapeutic emergency that can be life-threatening by its location, its repercussions or the misdiagnosis it can cause.</p><p><strong>Aim: </strong>To investigate the efficacy of analgesia by morphine versus that by low-dose ketamine in severe pain in emergency department.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>Low-dose ketamine appears to be non-inferior to morphine in achieving effective analgesia for severe pain in the emergency department.</p>","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":"102 11","pages":"886-892"},"PeriodicalIF":0.0000,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Acute severe pain in emergency department: Morphine or low-dose ketamine?\",\"authors\":\"Khedija Zaouche, Mohamed Kilani, Ramla Baccouche, Radhia Boubaker, Hamida Maghraoui\",\"doi\":\"10.62438/tunismed.v102i11.4574\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Severe pain is a therapeutic emergency that can be life-threatening by its location, its repercussions or the misdiagnosis it can cause.</p><p><strong>Aim: </strong>To investigate the efficacy of analgesia by morphine versus that by low-dose ketamine in severe pain in emergency department.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>Low-dose ketamine appears to be non-inferior to morphine in achieving effective analgesia for severe pain in the emergency department.</p>\",\"PeriodicalId\":38818,\"journal\":{\"name\":\"Tunisie Medicale\",\"volume\":\"102 11\",\"pages\":\"886-892\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-11-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Tunisie Medicale\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.62438/tunismed.v102i11.4574\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Tunisie Medicale","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.62438/tunismed.v102i11.4574","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
Acute severe pain in emergency department: Morphine or low-dose ketamine?
Introduction: Severe pain is a therapeutic emergency that can be life-threatening by its location, its repercussions or the misdiagnosis it can cause.
Aim: To investigate the efficacy of analgesia by morphine versus that by low-dose ketamine in severe pain in emergency department.
Methods: 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.
Results: 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).
Conclusions: 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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