Intranasal ketamine as an analgesic agent for acute pain management in emergency department: A literature review
Journal Title: Journal of Acute Disease - Year 2018, Vol 7, Issue 6
Abstract
Ketamine is a well-known dissociative anesthetic agent, and has been used over 50 years. Intranasal pathway is a mucosal way for absorbing agents to directly affect in brain via olfactory sheets, bypassing first pass metabolism and the blood brain barrier. The current uses of intranasal ketamine as an analgesic agent for acute pain management in emergency department are discussed in this review article. Using “ketamine”, “pain or analgesia”, and “intranasal” as keywords, a search of google scholar, Pubmed, web of science, and Medline database from 1970 until 2017 was performed. Finally, from 1 204 papers extracted via primary search, 1 088 papers were omitted and finally 10 studies were considered for further assessment. There were four observational studies, one case series and report and 5 clinical trials. Ketamine was used for acute pain control due to musculoskeletal trauma, burns, and painful procedures. A total of 390 cases were included in these studies. The studies used ketamine with doses ranging 0.45-1.25 mg/kg via intranasal pathway. Intranasal ketamine provides relatively rapid, well tolerated, and clinically significant analgesia for emergency department patients. Considering the lack of adequate studies and undetermined intranasal dose, it is better to conduct further high quality investigation in both adults and pediatrics.
Authors and Affiliations
Abdolghader Pakniyat, Morteza Qaribi, Dorin Rahnama Hezaveh, Ali Abdolrazaghnejad
Keywords
Related Articles
- EP ID EP429989
- DOI 10.4103/2221-6189.248028
- Views 116
- Downloads 0
Intervention of Peiyuan Huayu Decoction on the neuron damage in model rats with acute subdural hematoma
Objective: To study the intervention effect of Peiyuan Huayu Decoction on the neuron damage in model rats with acute subdural hematoma (ASDH). Methods: 160 SD rats were randomly divided into four groups, and the ASDH mod...
Cost analysis and characteristics of the patients admitted to emergency service with poisoning
Objective: To investigate the cost analysis and hospitalization rates and modes of poisoning of patients who applied to Bakent University Ankara Hospital Adult Emergency Service. Methods: Poisoning Patients who applied t...
"Reconciliation vessel" within de I-Ching book: Theoretical methodological analysis of its relevant hexagrams
The I-Ching is one of the most significant texts in the literature of the world and embodies, as no other text does, the Chinese spirit and thought. Its perpetuation along millennia has exercised crucial influence on t...
Emergent and delayed hybrid external fixation management of tibial pilon fractures: A multicentric retrospective analysis of 80 patients
Objective: To report our experience with the hybrid external fixator in emergency. Methods:We assessed 80 cases of pilon fracture treated with the external fixator during the period of January 2009 and December 2016:55 m...
Diagnostic value of biomarkers for sepsis in adult patients in the emergency department: Don't forget the neutrophil-lymphocyte count ratio
Objective: To determine and compare the diagnostic efficiency of various biomarkers [C-reactive protein, neutrophil percentage, neutrophil-lymphocyte ratio (NLCR), lactate, procalcitonin, blood culture] in the identifica...