Is Subdissociative Ketamine As Safe and Effective As Morphine for Pain Management in the Emergency Department?
| Autor: | Christine M. Gisness, Patricia Kunz Howard |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Emergency Nursing
law.invention Fentanyl 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Medicine Humans Pain Management Clinical significance Ketamine 030212 general & internal medicine Adverse effect Morphine business.industry 030208 emergency & critical care medicine Emergency department Middle Aged Confidence interval Anesthesia Emergency Medicine Female business medicine.drug |
| Zdroj: | Advanced emergency nursing journal. 39(2) |
| ISSN: | 1931-4493 |
| Popis: | Review of recent evidence with translation to practice for the advanced practice nurse (APN) role is presented using a case study module for "Intravenous Subdissociative-Dose Ketamine Versus Morphine for Analgesia in the Emergency Department: A Randomized Controlled Trial." This prospective, randomized controlled inquiry enrolled 90 patients into 2 groups (ketamine vs. morphine) for patients seeking care in an emergency department with acute pain. Data regarding pain scores were collected at baseline, 15, 30, 60, 90, and 120 min. Study subjects reporting persistent pain could receive rescue analgesia with fentanyl. Initial pain scores for the subjects in each of the groups were comparable (ketamine: 8.6; morphine: 8.5). Pain management for the 2 groups revealed similar average doses (ketamine: 21.8 mg; morphine: 7.7 mg). Although subjects in both groups reported reduction in pain scores at 15 and 30 min, no clinical significance was found. Subjects experienced greater pain relief (pain score = 0) in the ketamine group at 15 min (percentage difference 31%; 95% confidence interval [13, 49]), yet this was not sustained at the 30-min interval. There were no serious or life-threatening adverse effects in either group. This study highlights the important role of the APN in providing quality care, communication about pain management, and related follow-up care. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|