Low-dose ketamine as an analgesic agent in the emergency department: Efficacy and safety

INTRODUCTION: Interest in using low-dose ketamine (LDK) as an alternative analgesic to manage acute pain in the emergency department (ED) has increased. The aim of this systematic review was to compare and evaluate the analgesic effect and safety of LDK for the management of acute pain in the ED. METHOD: Databases were searched and all published articles that met the inclusion criteria were used. Electronic research was conducted on a total of 85 articles, and 13 articles that were relevant in terms of content, topic, and aim were selected for further review. The studies were analyzed and categorized after review. RESULTS: The results demonstrated that in 53.84% (7 of 13) of articles, a significant reduction or more than 50% reduction in pain in the group of patients treated with ketamine (alone or combined with other analgesics) was reported. However, in 46.15% (6 out of 13) of the reviewed articles, no significant difference was observed between the pain reduction in the groups treated with ketamine alone and ketamine with other analgesics. The highest decrease in numerical rating scale (NRS) score was 6 and the lowest was 1. There was also a 100% reduction in NRS score in 14 of 30 patients treated with 0.15 mg/kg ketamine and 0.5 mg/kg hydromorphone. CONCLUSION: According to the results of the present study, the use of LDK as an analgesic with low side effects can be suggested. However, further research is needed to determine the appropriate concentration with fewer side effects.