intranasal ketamine administration for narcotic dose decrement in patients suffering from acute limb trauma in emergency department: a double-blind randomized placebo-controlled trial

Introduction: pain management is an important and challenging issue in emergency medicine. despite the conduct of several studies on this topic, pain is still handled improperly in many cases. objective: this study investigated the effectiveness of low-dose in ketamine administration in reducing the need for opiates in patients in acute pain resulting from limb injury. method: this randomized, double-blind, placebo-controlled trial was conducted to assess the possible effect of low-dose intranasal (in) ketamine administration in decreasing patients' narcotic need. patients in emergency department suffering from acute isolated limb trauma were included. one group of patients received 0.5 mg/kg intravenous morphine sulfate and 0.02 ml/kg in ketamine. the other group received the same dose of morphine sulfate and 0.02 ml/kg in distilled water. pain severity was measured using the 11 points numerical rating scale at 0, 10, 30, 60, 120, and 180 minutes. results: ninety-one patients with mean age of 31.62 ± 9.13 years were enrolled (54.9% male). the number of requests for supplemental medication was significantly lower in patients who received ketamine (12 patients (30%)) than those who received placebo (27 patients (67.5%)) (p = 0.001). conclusion: it is likely that low-dose in ketamine is effective in reducing the narcotic need of patients suffering from acute limb trauma.