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Efficacy of nebulized fentanyl and low dose ketamine for pain control of patients with long bone fractures: A randomized, double-blind, clinical trial

INTRODUCTION: Fentanyl is a lipid soluble, highly potent opioid. The lipid solubility of fentanyl makes it an ideal opioid to be administrated by inhalation. The current study compared ketamine infusion and nebulized fentanyl in bone fracture pain relief. METHODS: In this double-blind, randomized cl...

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Autores principales: Maleki Verki, Mohammadreza, Mozafari, Javad, Tirandaz, Fateme, Motamed, Hassan, Khazaeli, Afsane
Formato: Online Artículo Texto
Lenguaje:English
Publicado: African Federation for Emergency Medicine 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6742599/
https://www.ncbi.nlm.nih.gov/pubmed/31528528
http://dx.doi.org/10.1016/j.afjem.2019.02.003
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author Maleki Verki, Mohammadreza
Mozafari, Javad
Tirandaz, Fateme
Motamed, Hassan
Khazaeli, Afsane
author_facet Maleki Verki, Mohammadreza
Mozafari, Javad
Tirandaz, Fateme
Motamed, Hassan
Khazaeli, Afsane
author_sort Maleki Verki, Mohammadreza
collection PubMed
description INTRODUCTION: Fentanyl is a lipid soluble, highly potent opioid. The lipid solubility of fentanyl makes it an ideal opioid to be administrated by inhalation. The current study compared ketamine infusion and nebulized fentanyl in bone fracture pain relief. METHODS: In this double-blind, randomized clinical trial, patients aged 18 to 55 years who were admitted to the emergency department (ED) with limb fracture were recruited. A total of 127 patients were included in the study, 51.1% (65) of whom were male and 48.9% (62) of whom were female. The patients were divided equally into two groups: Group I received 100 cm(3) IV infusion of normal saline and 4 μg/kg of 50 μg/ml nebulized fentanyl; Group II received 0.4 mg/kg ketamine in 10 min and 5 cm(3) nebulized normal saline. Pain was assessed using a visual analog scale just before treatment and 5, 10, 15, 30, and 60 min post-treatment. RESULTS: Before intervention, the pain scores of both groups showed no significant difference. However, log linear analysis in both groups showed a significantly decrement during the follow up (60 min) (p < 0.0001). Multiple comparison analysis showed that pain scores were significantly higher in the patients of Group I. Moreover, patients in Group I required additional treatment. CONCLUSION: Ketamine can be used as an alternative non-invasive treatment to successfully relieve pain in patients with limb fractures.
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spelling pubmed-67425992019-09-16 Efficacy of nebulized fentanyl and low dose ketamine for pain control of patients with long bone fractures: A randomized, double-blind, clinical trial Maleki Verki, Mohammadreza Mozafari, Javad Tirandaz, Fateme Motamed, Hassan Khazaeli, Afsane Afr J Emerg Med Original Article INTRODUCTION: Fentanyl is a lipid soluble, highly potent opioid. The lipid solubility of fentanyl makes it an ideal opioid to be administrated by inhalation. The current study compared ketamine infusion and nebulized fentanyl in bone fracture pain relief. METHODS: In this double-blind, randomized clinical trial, patients aged 18 to 55 years who were admitted to the emergency department (ED) with limb fracture were recruited. A total of 127 patients were included in the study, 51.1% (65) of whom were male and 48.9% (62) of whom were female. The patients were divided equally into two groups: Group I received 100 cm(3) IV infusion of normal saline and 4 μg/kg of 50 μg/ml nebulized fentanyl; Group II received 0.4 mg/kg ketamine in 10 min and 5 cm(3) nebulized normal saline. Pain was assessed using a visual analog scale just before treatment and 5, 10, 15, 30, and 60 min post-treatment. RESULTS: Before intervention, the pain scores of both groups showed no significant difference. However, log linear analysis in both groups showed a significantly decrement during the follow up (60 min) (p < 0.0001). Multiple comparison analysis showed that pain scores were significantly higher in the patients of Group I. Moreover, patients in Group I required additional treatment. CONCLUSION: Ketamine can be used as an alternative non-invasive treatment to successfully relieve pain in patients with limb fractures. African Federation for Emergency Medicine 2019-09 2019-03-03 /pmc/articles/PMC6742599/ /pubmed/31528528 http://dx.doi.org/10.1016/j.afjem.2019.02.003 Text en 2019 African Federation for Emergency Medicine. Publishing services provided by Elsevier. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Maleki Verki, Mohammadreza
Mozafari, Javad
Tirandaz, Fateme
Motamed, Hassan
Khazaeli, Afsane
Efficacy of nebulized fentanyl and low dose ketamine for pain control of patients with long bone fractures: A randomized, double-blind, clinical trial
title Efficacy of nebulized fentanyl and low dose ketamine for pain control of patients with long bone fractures: A randomized, double-blind, clinical trial
title_full Efficacy of nebulized fentanyl and low dose ketamine for pain control of patients with long bone fractures: A randomized, double-blind, clinical trial
title_fullStr Efficacy of nebulized fentanyl and low dose ketamine for pain control of patients with long bone fractures: A randomized, double-blind, clinical trial
title_full_unstemmed Efficacy of nebulized fentanyl and low dose ketamine for pain control of patients with long bone fractures: A randomized, double-blind, clinical trial
title_short Efficacy of nebulized fentanyl and low dose ketamine for pain control of patients with long bone fractures: A randomized, double-blind, clinical trial
title_sort efficacy of nebulized fentanyl and low dose ketamine for pain control of patients with long bone fractures: a randomized, double-blind, clinical trial
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6742599/
https://www.ncbi.nlm.nih.gov/pubmed/31528528
http://dx.doi.org/10.1016/j.afjem.2019.02.003
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