Low Dose Ketamine for Management of Acute Severe Pain in the Emergency Department
Pain

About this trial
This is an interventional treatment trial for Pain focused on measuring Ketamine, Acute pain, Pain control, Pain
Eligibility Criteria
Inclusion Criteria:
- English speaking
- Adults age 18-65
- Able to understand and give informed consent
- Comfortable with the experimental protocol as outlined to them by the research team
- Severe pain, pain score of at least 50/100 on Visual Analogue Scale (VAS) or 5/10 numerical ratings score
- Acute pain, pain duration < 7days
- Deemed by treating ED attending physician to require IV opioid analgesia
- ASA (American Society of Anesthesiologists) class I or II
Exclusion Criteria:
- Previously enrolled in the study
- Neurologic, respiratory, or hemodynamic compromise
- GCS (Glasgow Coma Scale) <15
- Pox <94%, RR <10, or RR >22
- SBP <90, SBP>180, or DBP >110
- Discretion of treating physician
- Pregnancy or breastfeeding
- Known or suspected allergy to ketamine or morphine
- Ketamine within 24 hours of presentation (prescription or illicit drugs)
- Conscious sedation in ED (per treating physician), includes ketamine (for non-study purposes)
- Known Renal (Cr>2.0) or Liver Failure
- Unstable psychiatric disease (as per treating physician)
- History of stroke
- History of cardiac disease
- Prior myocardial infarction; Angina (Stable or Unstable)
- Cardiac stents or bypass surgery
Sites / Locations
- Rhode Island Hospital
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Experimental
Placebo Comparator
LDK1: Low dose Ketamine (0.15mg/kg)
LDK2: Low dose Ketamine (0.3mg/kg)
0.9% Normal Saline
Participants randomized to the first group, LDK1, will receive an intravenous injection of low dose ketamine (0.15mg/kg). All participants, regardless of the group, will receive a dose of morphine(0.15mg/kg) at the same time the study drug is administered.
Participants randomized to the second group, LDK2, will receive an intravenous injection of low dose ketamine (0.3mg/kg). All participants, regardless of the group, will receive a dose of morphine(0.15mg/kg) at the same time the study drug is administered.
This group will receive a placebo injection of 0.9% normal saline of a similar volume (0.05ml/kg)