Monday, July 5, 2021

Nebulized Ketamine

REBEL EM - July 05, 2021 - By Salim Rezaie
Paper: Dove D et al. Comparison of Nebulized Ketamine at Three Different Dosing Regimens for Treating Painful Conditions in the Emergency Department: A Prospective, Randomized, Double-Blind Clinical Trial. Ann Emerg Med 2021. [Epub Ahead of Print]
Clinical Question: What is the analgesic effectiveness and safety of nebulized ketamine at 3 different doses for ED patients presenting with acute and chronic painful conditions?
Author Conclusion: “We found no difference between all 3 doses of ketamine administered through breath-actuated nebulizer for short-term treatment of moderate to severe pain in the emergency department.”
Clinical Take Home Point: 0.75mg/kg of nebulized ketamine was both efficacious and safe in the control of acute pain in the ED. Additionally, compared to previous evidence looking at IV sub-dissociative ketamine there appears to be a signal of decreased levels of psycho-perceptual effects and need for rescue analgesia. However, these last two findings would need to be studied in a trial comparing nebulized vs IV ketamine.