The effect of combined treatment with morphine sulphate and low-dose ketamine in a prehospital setting
(2009) In Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 17.- Abstract
- Background: Pain is a common condition among prehospital patients. The present study is designed to determine whether adding low-dose ketamine as additional analgesia improves the pain/nausea scores and hemodynamic parameters compared to morphine sulphate alone among patients with bone fractures. Methods: Prospective, prehospital clinical cohort study. Twenty-seven patients were included with acute pain. Eleven patients received morphine sulphate 0.2 mg/kg (M-group) and 16 patients received morphine sulphate 0.1 mg/kg combined with 0.2 mg/kg ketamine (MK-group). Scores for pain, nausea, sedation (AVPU) and the haemodynamic parameters (systolic blood pressures (BP), heart rate (HR) and peripheral oxygen saturation (SpO2) were recorded at... (More)
- Background: Pain is a common condition among prehospital patients. The present study is designed to determine whether adding low-dose ketamine as additional analgesia improves the pain/nausea scores and hemodynamic parameters compared to morphine sulphate alone among patients with bone fractures. Methods: Prospective, prehospital clinical cohort study. Twenty-seven patients were included with acute pain. Eleven patients received morphine sulphate 0.2 mg/kg (M-group) and 16 patients received morphine sulphate 0.1 mg/kg combined with 0.2 mg/kg ketamine (MK-group). Scores for pain, nausea, sedation (AVPU) and the haemodynamic parameters (systolic blood pressures (BP), heart rate (HR) and peripheral oxygen saturation (SpO2) were recorded at rescue scene before the start of analgesia and subsequently to admission at hospital. Results: Mean treatment time 46 +/- 17 minutes in the M-group and 56 +/- 11 minutes in the MK-group, respectively (ns). Mean doses of morphine sulphate in the M-group were 13.5 +/- 3.2 mg versus 7.0 +/- 1.5 mg in the MK-group. The mean additional doses of ketamine in the MK-group were 27.9 +/- 11.4 mg. There were significantly differences between the M-and the MK-group according to NRS scores for pain (5.4 +/- 1.9 versus 3.1 +/- 1.4) and BP (134 +/- 21 mmHg versus 167 +/- 32 mmHg) at admission at hospital, respectively (P < 0.05). All patients were Alert or respond to Voice and the results were similar between the groups. One patient versus 4 patients reported nausea in the M-and MK-group, respectively, and 3 patients vomited in the Mk-group (ns). Conclusion: We conclude that morphine sulphate with addition of small doses of ketamine provide adequate pain relief in patients with bone fractures, with an increase in systolic blood pressure, but without significant side effects. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1719744
- author
- Johansson, Patric ; Kongstad, Poul LU and Johansson, Anders LU
- organization
- publishing date
- 2009
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
- volume
- 17
- publisher
- BioMed Central (BMC)
- external identifiers
-
- wos:000283035600002
- scopus:79952278040
- pmid:19943920
- ISSN
- 1757-7241
- DOI
- 10.1186/1757-7241-17-61
- language
- English
- LU publication?
- yes
- additional info
- The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Division of Nursing (Closed 2012) (013065000), Neurosurgery (013026000)
- id
- 0855f374-3447-4ce2-8173-3af381cee873 (old id 1719744)
- date added to LUP
- 2016-04-01 13:24:04
- date last changed
- 2022-02-04 07:18:31
@article{0855f374-3447-4ce2-8173-3af381cee873,
abstract = {{Background: Pain is a common condition among prehospital patients. The present study is designed to determine whether adding low-dose ketamine as additional analgesia improves the pain/nausea scores and hemodynamic parameters compared to morphine sulphate alone among patients with bone fractures. Methods: Prospective, prehospital clinical cohort study. Twenty-seven patients were included with acute pain. Eleven patients received morphine sulphate 0.2 mg/kg (M-group) and 16 patients received morphine sulphate 0.1 mg/kg combined with 0.2 mg/kg ketamine (MK-group). Scores for pain, nausea, sedation (AVPU) and the haemodynamic parameters (systolic blood pressures (BP), heart rate (HR) and peripheral oxygen saturation (SpO2) were recorded at rescue scene before the start of analgesia and subsequently to admission at hospital. Results: Mean treatment time 46 +/- 17 minutes in the M-group and 56 +/- 11 minutes in the MK-group, respectively (ns). Mean doses of morphine sulphate in the M-group were 13.5 +/- 3.2 mg versus 7.0 +/- 1.5 mg in the MK-group. The mean additional doses of ketamine in the MK-group were 27.9 +/- 11.4 mg. There were significantly differences between the M-and the MK-group according to NRS scores for pain (5.4 +/- 1.9 versus 3.1 +/- 1.4) and BP (134 +/- 21 mmHg versus 167 +/- 32 mmHg) at admission at hospital, respectively (P < 0.05). All patients were Alert or respond to Voice and the results were similar between the groups. One patient versus 4 patients reported nausea in the M-and MK-group, respectively, and 3 patients vomited in the Mk-group (ns). Conclusion: We conclude that morphine sulphate with addition of small doses of ketamine provide adequate pain relief in patients with bone fractures, with an increase in systolic blood pressure, but without significant side effects.}},
author = {{Johansson, Patric and Kongstad, Poul and Johansson, Anders}},
issn = {{1757-7241}},
language = {{eng}},
publisher = {{BioMed Central (BMC)}},
series = {{Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine}},
title = {{The effect of combined treatment with morphine sulphate and low-dose ketamine in a prehospital setting}},
url = {{http://dx.doi.org/10.1186/1757-7241-17-61}},
doi = {{10.1186/1757-7241-17-61}},
volume = {{17}},
year = {{2009}},
}