Intranasal Ketamine as a Supplement to Local Anesthesia to Reduce Pain Associated With Minor Procedures in the Emergency Department
Loyola University
Summary
This trial is a double-blind randomized controlled clinical trial of adults and children (ages 7 to less than 70 years). Patients who present to the ED and who undergo minor bedside procedures that require local anesthesia will be divided into two groups: The first group will be treated with 0.7 mg/kg intranasal ketamine as well as standard local anesthesia for the procedure (treatment cohort). The second group will be treated with a volume-based dose of intranasal saline solution as well as standard local anesthesia for the procedure (control cohort). The primary aim is to assess whether patients in the treatment cohort report lower pain scores on the Numerical Rating Scale (NRS-100) when compared to patients in the control cohort. For adult patients, a secondary aim is to compare agitation between the two cohorts using the Richmond Agitation Sedation Scale (RASS) and, for pediatric patients, a secondary aim is to compare alertness between the two cohorts using the University of Michigan Sedation Scale (UMSS). Results obtained from specific procedures will be analyzed on a spectrum of complexity and general length of recovery time. Scientific achievements may include finding a safe and effective way to reduce pain and discomfort during minor procedures in the Emergency Department. Additionally, it would provide opportunities for more research on sub-dissociative doses of ketamine during minor procedures: a topic in which there is still a gap in the published research
Description
Patient experiences in the emergency department (ED) are commonly painful and uncomfortable, particularly when patients must undergo procedures. Managing acute pain and procedural pain for minor procedures in the ED can be challenging. Ketamine is an N-methyl-D aspartate receptor agonist gaining popularity in clinical settings and has also been shown in several studies to potentially treat depression. Several randomized clinical studies have shown that ketamine is a comparable pain relief medication to opioid analgesics in both acute pain and traumatic settings. Its uses for pain control in th…
Eligibility
- Age range
- 7–70 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Undergoing Minor Procedure in the ED * Weight not to exceed 115kg Exclusion Criteria: * Altered Mental Status * Pregnancy * Breastfeeding * Acute head or eye injury * Intercranial Hypertension * Hx of seizures * Hx of chronic pain * Unstable vital signs * Allergy to Ketamine * Hepatic or Renal Insufficiency * Hx of Psychiatric Illness * Hx of alcohol/drug abuse
Interventions
- DrugKetamine
Ketamine is an N-methyl-D aspartate receptor agonist
- OtherSaline
Intranasal saline flushes pollen, dust, and other debris from nasal passages. It also removes excess mucus and adds moisture
Location
- Loyola University Medical CenterMaywood, Illinois