Ketamine administration for acute painful sickle cell crisis: A randomized controlled trial.
Acad Emerg Med
; 29(2): 150-158, 2022 02.
Article
in En
| MEDLINE
| ID: mdl-34449939
ABSTRACT
OBJECTIVE:
The objective was to evaluate the efficacy and safety of single-dose ketamine infusion in adults with sickle cell disease (SCD) who presented with acute sickle vasoocclusive crisis (VOC).METHODS:
This study was a parallel-group, prospective, randomized, double-blind, pragmatic trial. Participants were randomized to receive a single dose of either ketamine or morphine, infused over 30 min. Primary outcome was mean difference in the numerical pain rating scale (NPRS) score over 2 h. NPRS was recorded every 30 min for a maximum of 180 min and secondary outcomes were cumulative dose of opioids, emergency department (ED) length of stay, hospital admission, change in vital signs, and drug-related side effects. Authors performed the analysis using intention-to-treat principle.RESULT:
A total of 278 adults with SCD and who presented with acute sickle VOC participated in this trial. A total of 138 were allocated to the ketamine group. Mean (±standard deviation [SD]) NPRS scores over 2 h were 5.7 (±2.13) and 5.6 (±1.90) in the ketamine and morphine groups. The ketamine group received significantly lower cumulative doses of morphine during their ED stay (mean ± SD = 4.5 ± 4.6 mg) than of the morphine group (mean ± SD = 8.5 ± 7.55 mg). Both groups had similar rates of hospital admission 6.3% in the ketamine group had drug-related side effects compared to 2.2% in the morphine group.CONCLUSION:
Early use of ketamine in adults with VOC resulted in a meaningful reduction in pain scores over a 2-h period and reduced the cumulative morphine dose in the ED with no significant drug-related side effects in the ketamine-treated group.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Acute Pain
/
Anemia, Sickle Cell
/
Ketamine
Type of study:
Clinical_trials
/
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limits:
Humans
Language:
En
Journal:
Acad Emerg Med
Journal subject:
MEDICINA DE EMERGENCIA
Year:
2022
Document type:
Article