Ketamine could help reduce opioid use in the ED

The authors of a new meta-analysis believe that, in the face of raging opioid abuse and dependence, ketamine could be a safe and reasonable alternative for treating acute pain in the emergency department (ED). Although the powerful anesthetic has gained a reputation as a club drug, it is safe, effective, and well-tolerated in the medical setting.

The authors of a new meta-analysis believe that, in the face of raging opioid abuse and dependence, ketamine could be a safe and reasonable alternative for treating acute pain in the emergency department (ED). Although the powerful anesthetic has gained a reputation as a club drug, it is safe, effective, and well-tolerated in the medical setting. It is not especially addictive and is not known to trigger respiratory depression, although it does have some dissociative psychological effects. Its use has been studied for the purpose of treating migraine, addiction, and depression, among other conditions; and now, researchers at the Washington University School of Medicine in St. Louis are exploring its possible use to independently manage acute pain in the ED. A search of the literature turned up only three trials that met their criteria. Looking at data for the 261 participants, the review authors concluded that ketamine was not inferior to morphine. The drug was associated with more adverse events, but these were not severe in nature. Based on the findings, the researchers declare that "emergency physicians can feel comfortable using [ketamine] instead of opioids" when appropriate, but not universally. The meta-analysis results appear in <I>Academic Emergency Medicine</I>.