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The Use of Ketamine as an Adjunct to Treating Opioid Refractory Cancer-Related Pain in the Emergency Department

The Use of Ketamine as an Adjunct to Treating Opioid Refractory Cancer-Related Pain in the... The Research to Practice column is designed to provide advanced practice registered nurses (APRNs) with an analysis of a current research topic with implications for practice change within the emergency care settings. This review examines a recent study conducted by K. J. Bowers, K. B. McAllister, M. Ray, and C. Heitz (2017) entitled “Ketamine as an adjunct to opioids for acute pain in the emergency department: A randomized controlled trial.” The authors conducted a randomized, double-blinded, placebo-controlled trial at a single academic emergency department (ED) to compare standard opioid pain control in the ED population to the use of ketamine in conjunction with opioids in the same population. Participants were randomized into either the ketamine group, receiving 0.1 mg/kg of ketamine in conjunction with an intravenous opioid, or to the control group, receiving an equivalent volume of normal saline in addition to an intravenous opioid. Participants were evaluated for adequacy of pain control, side effects, and level of sedation every 30 min up to the 120-min time point. Data revealed that patients receiving ketamine had a statistically significant lower mean pain score, 0.6512 (p = 0.0083), compared with patients in the control group. The data also showed that patient satisfaction with pain control was similar for the ketamine group and the control group. These and other associated findings have implications for APRN practice, including managing acute pain in the ED setting and preventing hospital admission of acute-on-chronic pain exacerbations in the ED. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Advanced Emergency Nursing Journal Wolters Kluwer Health

The Use of Ketamine as an Adjunct to Treating Opioid Refractory Cancer-Related Pain in the Emergency Department

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Publisher
Wolters Kluwer Health
Copyright
© 2019 Wolters Kluwer Health, Inc. All rights reserved.
ISSN
1931-4485
eISSN
1931-4493
DOI
10.1097/TME.0000000000000244
Publisher site
See Article on Publisher Site

Abstract

The Research to Practice column is designed to provide advanced practice registered nurses (APRNs) with an analysis of a current research topic with implications for practice change within the emergency care settings. This review examines a recent study conducted by K. J. Bowers, K. B. McAllister, M. Ray, and C. Heitz (2017) entitled “Ketamine as an adjunct to opioids for acute pain in the emergency department: A randomized controlled trial.” The authors conducted a randomized, double-blinded, placebo-controlled trial at a single academic emergency department (ED) to compare standard opioid pain control in the ED population to the use of ketamine in conjunction with opioids in the same population. Participants were randomized into either the ketamine group, receiving 0.1 mg/kg of ketamine in conjunction with an intravenous opioid, or to the control group, receiving an equivalent volume of normal saline in addition to an intravenous opioid. Participants were evaluated for adequacy of pain control, side effects, and level of sedation every 30 min up to the 120-min time point. Data revealed that patients receiving ketamine had a statistically significant lower mean pain score, 0.6512 (p = 0.0083), compared with patients in the control group. The data also showed that patient satisfaction with pain control was similar for the ketamine group and the control group. These and other associated findings have implications for APRN practice, including managing acute pain in the ED setting and preventing hospital admission of acute-on-chronic pain exacerbations in the ED.

Journal

Advanced Emergency Nursing Journal – Wolters Kluwer Health

Published: Apr 1, 2019

References

  • Ketamine as an adjunct to opioids for acute pain in the emergency department: A randomized controlled trial
  • Emerging trends in pain medication management: Back to the future: A focus on ketamine
  • Systematic review of the use of low-dose ketamine for analgesia in the emergency department
  • Is subdissociative ketamine as safe and effective as morphine for pain management in the emergency department?
  • Ketamine protocol for palliative care in cancer patients with refractory pain
  • Hospital admission of cancer patients: Avoidable practice or necessary care?
  • Navigating cancer pain management in the midst of the opioid epidemic
  • Evaluation of emergency department management of opioid-tolerant cancer patients with acute pain
  • Low dose ketamine use in the emergency department, a new direction in pain management
  • Low dose ketamine in the age of opioids
  • Successful treatment of opioid-refractory cancer pain with short-course, low-dose ketamine