alexa Single Dose versus Weight Based Dose Intra Nasal Ketami
ISSN: 2165-7548

Emergency Medicine: Open Access
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Research Article

Single Dose versus Weight Based Dose Intra Nasal Ketamine for ED Management of Acute Musculoskeletal Pain

Sara Payami1, Mohammad Taghi Talebian2, Ali Ardalan3, Reza Shariat Moharari4, Fateme Hojjati5 and Amir Nejati2*

1Emergency Department, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran

2Emergency Department & Hospital and Pre-Hospital Emergencies Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran

3Department of Disaster and Emergency Health, National Institute of Health Research, and Department of Disaster Public Health, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

4Anesthesiology Department, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran

5Physical Medicine and Rehabilitation Department, Shohada Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

*Corresponding Author:
Amir Nejati
Associate Professor of Emergency Medicine
Emergency Department, Imam Khomeini Hospital, Tehran, Iran
Tel: 00989121256690, 004676922466
E-mail: [email protected]

Received Date: October 31, 2015; Accepted Date: Decemberr 17, 2015; Published Date: December 24, 2015

Citation: Payami S, Talebian MT, Ardalan A, Moharari RS, Hojjati F, et al. (2015) Single Dose versus Weight Based Dose Intra Nasal Ketamine for ED Management of Acute Musculoskeletal Pain. Emergency Med 6:302. doi:10.4172/2165-7548.1000302

Copyright: © 2015 Payami S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.



Background: Ketamine has been used widely in emergency departments for different procedures, prescribed only as a single dose or dose per weight. We compared single dose of ketamine with dose per weight ketamine for procedures done in cases with acute musculoskeletal pain.
Methods: This randomized double blind clinical trial, was conducted in the emergency department of Imam Khomeini Hospital during March and June 2012. Patients with traumatic or non-traumatic musculoskeletal pain with numeric rating scale (NRS) ≥ 4 were enrolled. Patients were divided to Weight groups and for each group 4 syringes with the same shape were considered. BP, PR, RR, O2 sat, level of consciousness and all complications were checked for the patients in minutes 20 and 30. First group received 50 mg and second group received 0.75 mg/kg intranasal ketamine.
Results: Out of 136 patients enrolled in this study, 27 cases were excluded. Patients were divided to two groups of 60 (dose per kg) and 59 (single dose) persons. The most type of injuries were fractures (37.8%) followed by lacerations (26%). O 2 sat, HR, systolic and diastolic BP and Mean NRSs before and after procedures were not significantly different in the two groups. Mean NRS reduction was not significant between two groups (comparing NRS at baseline with NRS at minutes 30, 40 and 60).
Discussion: Our study showed that 50 mg single dose of ketamine is the same as the 0.75 mg/kg dose per weight for reducing pain in cases with traumatic and non-traumatic musculoskeletal injuries.


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