Low-Dose Analgesic Deemed a Potential Alternative to Opioids

Low-dose ketamine may be a potential alternative to opioids for the treatment of acute pain in the emergency department (ED) setting, according to a recent systematic review and meta-analysis.

A total of 3 randomized controlled trials were included in the analysis. Each trial had compared intravenous opioids to low-dose ketamine for acute pain relief in the ED. No participants in any of the 3 studies had received opioids prior to ketamine.

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An electronic search strategy designed by a research librarian was implemented. The relative effects of low-dose ketamine and opioids for the treatment of acute pain were determined by examining changes in the visual analog scale or numeric rating pain scales.

After the analysis, ketamine was deemed noninferior to morphine on pain scale reduction, with a relative reduction of 0.42.

No severe events occurred in any study, but nonsevere adverse events were more common with ketamine use vs morphine use.

“Ketamine is noninferior to morphine for the control of acute pain, indicating that ketamine can be considered as an alternative to opioids for ED short‐term pain control,” the researchers concluded.

—Christina Vogt

Reference:

Karlow N, Schlaepfer CH, Stoll CRT, et al. A systematic review and meta-analysis of ketamine as an alternative to opioids for acute pain in the emergency department [Published online July 17, 2018]. Acad Emerg Med. https://doi.org/10.1111/acem.13502