Ketamine Infusion not Much Effective For Pain Management in Rib Fracture Patients But Decreased Oral Morphine Equivalent Utilization

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Ketamine Infusion not Much Effective For Pain Management in Rib Fracture Patients But Decreased Oral Morphine Equivalent Utilization

According to the Journal of Trauma and Acute Care Surgery, low dose ketamine (LDK) found unable to lessen the pain or oral morphine usage in the patients with rib fractures. A total of 40% of trauma patients were presented with rib fractures and prolonged mortality. Opiate-based pain approaches considered as the base of rib fracture management; but, problems about opioids have raised the interest of investigators in alternative approaches. The recently used medication instead of opioids is Ketamine, but the evidence regarding its efficacy is limited.

The adults with ≥three rib fractures, >64 years old, use who chronic opiate and with <13 GCS admitted to a Level 1 trauma center were selected for analysis. The patients of the experimental group obtained 2.5 mcg/kg/min LDK and placebo achieved an equivalent rate of 0.9% normal saline. All infusions proceeded for two days. Reduction in numeric pain score (NPS) at the first 24 hours were considered as the primary endpoint and length of stay, pulmonary complications, oral morphine equivalent (OME) utilization, adverse events, and epidural rates were regarded as the secondary endpoints.

A total of 45 out of 91 individuals with mean 49 years old with an ISS of 14 completed the analysis. The pattern was the same for both groups. LDK was not correlated with a significant decrease in 24-hour OME or NPS totals. However, during the subgroup analysis of 45 critically injured individuals showed an association between LDK and a significant reduction in OME use at the first 24-hours, 24-48 hours, and overall. The groups exhibited no difference in other secondary endpoints or adverse events. Further, affirmative studies are needed to define if LDK is a beneficial adjunct in seriously injured subjects.

Source

Journal of Trauma and Acute Care Surgery

Link to the source:

https://www.ncbi.nlm.nih.gov/pubmed/30376537

Original title of the article:

Ketamine Infusion for Pain Control in Adult Patients with Multiple Rib Fractures: Results of a Randomized Control Trial

Authors:

Thomas W. Carver et al.

SearchTags: 
Therapeutic, Ketamine, Anesthesia, Osteoporosis, Ribs, Randomized Control Trial, Efficacy, Safety, NPS, OME
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