Management of severe acute pain in emergency settings: ketamine reduces morphine consumption - 09/08/11
, François Dolveck, MD b, Xavier Combes, MD e, Véronique Limoges, MD c, Nadia Smaïl, MD, PhD d, Véronique Pommier, MD c, François Templier, MD b, Jean Catineau, MD a, Frédéric Lapostolle, MD a, Frédéric Adnet, MD, PhD aAbstract |
Objective |
The aim of the study was to compare in emergency settings 2 analgesic regimens, morphine with ketamine (K group) or morphine with placebo (P group), for severe acute pain in trauma patients.
Methods |
This was a prospective, multicenter, randomized, double-blind, clinical trial. Seventy-three trauma patients with a severe acute pain defined as a visual analog scale (VAS) score of at least 60/100 were enrolled. Patients in the K group received 0.2 mg · kg−1 of intravenous ketamine over 10 minutes, and patients in the P group received isotonic sodium chloride solution. In both groups, patients were given an initial intravenous morphine injection of 0.1 mg · kg−1, followed by 3 mg every 5 minutes. Efficient analgesia was defined as a VAS score not exceeding 30/100. The primary end points were morphine consumption and VAS at 30 minutes (T30).
Results |
At T30, morphine consumption was significantly lower in the K group vs the P group, with 0.149 mg · kg−1 (0.132-0.165) and 0.202 mg · kg−1 (0.181-0.223), respectively (P < .001). The VAS score at T30 did not differ significantly between the 2 groups, with 34.1 (25.6-42.6) in the K group and 39.5 (32.4-46.6) in the P group (P = not significant).
Conclusion |
Ketamine was able to provide a morphine-sparing effect.
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| Presented at the European Society of Anaesthesiology Congress in Madrid, Spain, June 3-6, 2006. |
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| ☆ | Support was provided solely by institutional and/or departmental sources. |
Vol 25 - N° 4
P. 385-390 - mai 2007 Retour au numéro
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