title: Low-dose ketamine for analgesia in the ED: a retrospective case series.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Emergency Medicine, University of New Mexico, Albuquerque, NM 87131-0001, USA. llester@salud.unm.edu
authors.forename: Laeben
authors.initials: L
authors.lastname: Lester
authors.forename: Darren A
authors.initials: DA
authors.lastname: Braude
authors.forename: Christopher
authors.initials: C
authors.lastname: Niles
authors.forename: Cameron S
authors.initials: CS
authors.lastname: Crandall
mesh_terms: D000328:Adult; D000698:Analgesia / Q000379:methods* / Q000706:statistics & numerical data; D000700:Analgesics / Q000627:therapeutic use*; D004636:Emergency Service, Hospital; D004638:Emergency Treatment / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D006785:Hospitals, University; D006801:Humans; D007649:Ketamine / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology; D010147:Pain Measurement; D018579:Patient Selection; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies; D012449:Safety; D014193:Trauma Centers; D016896:Treatment Outcome
chemical_list: D000700:Analgesics; D007649:Ketamine