Low-dose ketamine for analgesia in the ED: a retrospective case series
Low-dose ketamine for analgesia in the ED: a retrospective case series
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DOI：
10.1016/j.ajem.2009.07.023
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发表时间：
2010-09-01
影响因子：
3.6
通讯作者：
Crandall, Cameron S.
中科院分区：
文献类型：
--
作者：
Lester, Laeben;Braude, Darren A.;Crandall, Cameron S.
目的：本研究的目的是描述低剂量氯胺酮（LDK）镇痛在急诊科（艾德）的使用和效果。方法：进行图表审查，以确定所有成年患者接受LDK镇痛在我们的ED。低剂量氯胺酮定义为给予0.1 - 0.6 mg/kg氯胺酮以控制疼痛。排除了在手术镇静期间使用氯胺酮。结果：35例患者在艾德接受LDK治疗2年。剂量范围为5至35 mg。35例中有30例（86%）为静脉给药，5例（14%）为肌内给药。在35例病例中，32例（91%）在LDK之前给予阿片类药物或与LDK共同给予阿片类药物，在其余3例病例中，在患者来到ED之前使用阿片类药物。在35例患者接受LDK的病例中，19例（54%）观察到疼痛改善。35例病例中有8例（23%）的疼痛评分未改善。数据不足以确定35例病例中8例（23%）的LDK效应。在任何35 cases.Conclusions：LDK在艾德的管理可能是一个安全和有效的辅助镇痛在某些患者中的任何显着的不良事件被确定。然而，在广泛使用LDK用于艾德的镇痛之前，需要进行前瞻性随机对照试验。(C)2010年爱思唯尔公司All rights reserved.
Objectives: The aim of this study was to describe the use and effect of low-dose ketamine (LDK) for analgesia in the emergency department (ED).Methods: A chart review was performed to identify all adult patients who received LDK for analgesia in our ED. Cases were identified by pharmacy record of ketamine administration. Low-dose ketamine was defined as the administration of 0.1 to 0.6 mg/kg of ketamine for pain control. Use of ketamine during procedural sedation was excluded. Data were analyzed descriptively.Results: Thirty-five cases in which patients received LDK in the ED for a 2-year period were identified. Doses ranged from 5 to 35 mg. Administration was intravenous in 30 (86%) of 35 cases and intramuscular in 5 (14%) of 35 cases. Opioids were administered before or coadministered with LDK in 32 (91%) of 35 cases, and in the remaining 3 cases, opioids were used before the patient came to the ED. Improvement in pain was observed in 19 (54%) of 35 cases in which patients received LDK. Pain scores did not improve in 8 (23%) of 35 cases. Insufficient data were available to determine LDK effect for 8 (23%) of 35 cases. No significant adverse events were identified in any of the 35 cases.Conclusions: The administration of LDK in the ED may be a safe and effective adjunct for analgesia in some patients. However, prospective randomized controlled trials are needed before widespread use of LDK for analgesia in the ED can be recommended. (C) 2010 Elsevier Inc. All rights reserved.