How to Administer Low-Dose IV Ketamine for Pain in the ED

Back in 2015, Dr. Sergey Motov’s (@painfreeED) group published a study demonstrating the efficacy of low-dose ketamine compared to morphine for analgesia in the ED. Here’s my quick analysis of that study as a UMEM pearl. The question, though, is how best to administer the 0.3 mg/kg IV ketamine dose while minimizing the risk of adverse effects.

Fortunately, Dr. Motov’s group has just published a follow-up study addressing that exact question.
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Ketamine as a First-Line Treatment for Severe Agitation in the ED

Ketamine is steadily gaining traction as a treatment option for excited delirium and/or severe agitation in both the prehospital and ED settings. We published a summary of the available data back in 2015 on Academic Life in EM. Last year in 2016, two prospective studies added important information to our understanding of the role of ketamine; one in the prehospital setting by Dr. Jon Cole’s group out of Minnesota and one in the ED from Dr. Geoffrey Isbister’s group in Australia. I was invited to write a commentary along with the Cole study, also published in 2016.

Hot off the press in 2017 is another prospective study, this time from Dr. Jeff Riddell’s group in California (@Jeff__Riddell).
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