Authors: Jana L. Anderson, MD and Lucas Oliveira J. e Silva, MD
Dr. Anderson is a pediatric emergency physician in the Department of Emergency Medicine at Mayo Clinic, Rochester, MN.
Dr. Silva is a research fellow in the Department of Emergency Medicine at Mayo Clinic, Rochester, MN.
The emergency department is the front line for pain control for acute and many times chronic issues. Given the current climate of opioid use and abuse, alternatives to opioids are being sought. Recently, the EM research division of Mayo Clinic reviewed and analyzed the current evidence of intranasal (IN) ketamine for pain control in children presenting to the emergency department. IN ketamine was found to be equally efficacious as IN fentanyl for pain control. No serious side-effects were found with IN ketamine. The next step is to determine if the benefit of avoiding opioids is worth the non-serious side effects that are higher with IN ketamine.
Overall summary of our systematic review and meta-analysis:
Please read our article in The American Journal of Emergency Medicine in order to obtain more details about the use of IN ketamine as an alternative to opioids in children having significant pain in the emergency department.