Ketamine for the Treatment of Acute Pain in the Pre-Hospital and Emergency Department Setting: A Systematic Review

摘要

Background: Ketamine has been utilized to manage acute pain. Observational studies have demonstrated pain relief with ketamine as monotherapy, in combination with opioids, and after opioids have failed. Objective: To compare the efficacy and safety of ketamine monotherapy, or as an adjuvant to opioids, for the treatment of acute pain in the pre-hospital or ED setting. Methods: MEDLINE, EMBASE, CENTRAL, Google and ClinicalTrials.gov were searched from inception to October 2016 using the search terms: ketamine; acute pain; pain management; analgesia; emergency service, hospital emergency department; pre-hospital out-of-hospital. Randomized controlled trials (RCTs) investigating ketamine compared to placebo or active comparators in adult or pediatric patients with acute pain in the pre-hospital or ED setting were included. The quality of included trials was evaluated using The Cochrane Collaborations risk of bias tool.