ketamine and Acute Pain studies

Ketamine: A cyclohexanone derivative used for induction of anesthesia. Its mechanism of action is not well understood, but ketamine can block NMDA receptors (RECEPTORS, N-METHYL-D-ASPARTATE) and may interact with sigma receptors.
ketamine : A member of the class of cyclohexanones in which one of the hydrogens at position 2 is substituted by a 2-chlorophenyl group, while the other is substituted by a methylamino group.

Acute Pain: Intensely discomforting, distressful, or agonizing sensation associated with trauma or disease, with well-defined location, character, and timing.

Research Excerpts

Excerpt	Relevance	Reference
" Due to the reduction of this symptom with Haloperidol, we decided to design a randomized clinical trial to compare the analgesic effect of Ketamine with Haloperidol and Fentanyl in reducing acute pain and its complications."	9.51	Sub dissociative dose of ketamine with haloperidol versus fentanyl on pain reduction in patients with acute pain in the emergency department; a randomized clinical trial. ( Baratloo, A; Moradi, MM; Payandemehr, P; Safaie, A, 2022)
"ketamine has potential advantages over morphine for musculoskeletal pain relief."	9.51	Non-inferiority of intranasal ketamine compared to intravenous morphine for musculoskeletal pain relief among older adults in an emergency department: a randomised controlled trial. ( Paksophis, T; Sri-On, J; Thong-On, K; Tongbua, S, 2022)
" S(+)-ketamine is an N-methyl-D-aspartic acid (NMDA) receptor antagonist with a strong analgesic effect and can significantly relieve postoperative acute pain and reduce opioid consumption."	9.51	Evaluation of the effect of perioperative administration of S(+)-ketamine hydrochloride injection for postoperative acute pain in children: study protocol for a prospective, multicenter, randomized, open-label, parallel-group, pragmatic clinical trial. ( Chen, P; Duan, C; Lan, C; Mi, W; Qu, S; Sun, Y; Wang, H; Yang, L; Zhang, J; Zhou, L, 2022)
"The purpose of this study is to investigate if an orally administered combination of aspirin and ketamine will provide better analgesia than a ketamine alone in adult patients presenting to the Emergency Department (ED) with acute musculoskeletal pain."	9.51	Oral Aspirin/ketamine versus oral ketamine for emergency department patients with acute musculoskeletal pain. ( Barberan, C; Correa Bravo, S; Davis, A; Drapkin, J; Fassassi, C; Gerges, L; Gohel, A; Hossain, R; Likourezos, A; Motov, S; Niceforo, P; Silver, M, 2022)
"The Ketamine for Acute Pain Management After Trauma (KAPT) with registration # NCT04129086 was registered on October 16, 2019."	9.51	Ketamine for acute pain after trauma: the KAPT randomized controlled trial. ( Balogh, J; Green, C; Harvin, JA; Kao, LS; Klugh, J; Prater, SJ; Puzio, TJ; Sergot, PB; Stephens, CT; Wade, CE; Wandling, MW, 2022)
"Low-dose ketamine might have higher or equivalent efficacy and safety when compared to opioids for managing acute pain among patients presenting to the emergency setting."	9.41	Efficacy of Low-dose Ketamine for Control of Acute Pain in the Emergency Setting: A Systematic Review and Meta-analysis of Randomized Controlled Trials. ( Ying, M; Zuo, Y, 2023)
"Ketamine is an N-methyl-D-aspartate receptor (NMDA) antagonist used widely as an intravenous analgesic for treatment of acute pain."	9.41	Efficacy and Tolerability of Oral Compared with Sublingual Ketamine Lozenges as Rescue Analgesics in Adults for Acute Pain: The OSKet Trial. ( Chong, CC; Schug, SA, 2021)
"To evaluate the effectiveness of a subanaesthetic single-dose ketamine (SDK) as an adjunct to opioids for acute pain in emergency department (ED) settings."	9.41	Subanaesthetic single-dose ketamine as an adjunct to opioid analgesics for acute pain management in the emergency department: a systematic review and meta-analysis. ( Fjendbo Galili, S; Nikolajsen, L; Papadomanolakis-Pakis, N, 2023)
"Given that combinations of morphine with low doses of ketamine in patients with renal colic pain causes more pain and morphine consumption reduction then this combination is suggested as an alternative treatment that could be utilized in patients with renal colic."	9.27	Can low-dose of ketamine reduce the need for morphine in renal colic? A double-blind randomized clinical trial. ( Abbasi, S; Bidi, N; Farsi, D; Hafezimoghadam, P; Mahshidfar, B; Mofidi, M; Rezai, M, 2018)
"Ketamine PCA led to lower cumulative opioid consumption and lower oxygen supplementation requirements, though hallucinations occurred more frequently with use of ketamine."	9.27	Ketamine versus hydromorphone patient-controlled analgesia for acute pain in trauma patients. ( Branson, RD; Droege, CA; Droege, ME; Ernst, N; Gerlach, TW; Johannigman, JA; Mueller, EW; Robinson, BRH; Takieddine, SC; Webb, M, 2018)
" The evidence generated by this study is that ketamine is non-inferior to opioids (morphine and fentanyl) in controlling acute pain in children."	9.22	The Effectiveness of Ketamine Compared to Opioid Analgesics for management of acute pain in Children in The Emergency Department: systematic Review. ( Alanazi, E, 2022)
"To compare the maximum change in numeric rating scale (NRS) pain scores, in patients receiving low-dose ketamine (LDK) or morphine (MOR) for acute pain in the emergency department."	9.20	Low-dose ketamine vs morphine for acute pain in the ED: a randomized controlled trial. ( Bebarta, VS; Ganem, VJ; Miller, JP; Schauer, SG, 2015)
"Low-dose ketamine has been used perioperatively for pain control and may be a useful adjunct to intravenous (IV) opioids in the control of acute pain in the emergency department (ED)."	9.19	Low-dose ketamine improves pain relief in patients receiving intravenous opioids for acute pain in the emergency department: results of a randomized, double-blind, clinical trial. ( Beaudoin, FL; Guan, W; Lin, C; Merchant, RC, 2014)
"The aim was to review current evidence regarding the off-label use of intranasal ketamine for acute pain presenting in the setting of the emergency department, and secondary to pediatric limb injuries, renal colic, digital nerve block, and migraines."	9.12	Intranasal Ketamine for Acute Pain. ( Rocchio, RJ; Ward, KE, 2021)
"There may be a role of IN ketamine for acute pain management in adults in an emergency setting."	9.12	Efficacy of intranasal ketamine for acute pain management in adults: a systematic review and meta-analysis. ( Hua, GC; Li, X; Peng, F, 2021)
"There has been increased interest in the use of low-dose ketamine (LDK) as an alternative analgesic for the management of acute pain in the emergency department (ED)."	9.12	Low-dose Ketamine For Acute Pain Control in the Emergency Department: A Systematic Review and Meta-analysis. ( Balzer, N; Grewal, K; McLeod, SL; Walsh, C, 2021)
"Intranasal ketamine has not been well studied in acute pain treatment and does not have a recognized place in therapy in current practice guidelines for pediatric patients."	9.05	Intranasal Ketamine for Treatment of Acute Pain in Pediatrics: A Systematic Review. ( Beckett, RD; Ferguson, CL, 2020)
"To assess the efficacy and safety of intranasal analgesic-dose ketamine as compared to intranasal fentanyl for pediatric acute pain."	9.05	Intranasal ketamine for acute pain management in children: A systematic review and meta-analysis. ( Anderson, JL; Bellolio, F; Homme, JL; Lee, JY; Oliveira J E Silva, L, 2020)
"Ketamine has been studied as an alternative to opioids for acute pain in the emergency department setting."	9.01	Hot Off the Press: A Systematic Review And Meta-analysis of Ketamine as an Alternative to Opioids for Acute Pain in the Emergency Department. ( Bond, C; Heitz, C; Milne, WK; Morgenstern, J, 2019)
"To evaluate the efficacy and safety of perioperative intravenous ketamine in adult patients when used for the treatment or prevention of acute pain following general anaesthesia."	8.98	Perioperative intravenous ketamine for acute postoperative pain in adults. ( Bell, RF; Brinck, EC; Heesen, M; Kontinen, V; Moore, RA; Straube, S; Tiippana, E, 2018)
"Ketamine is noninferior to morphine for the control of acute pain, indicating that ketamine can be considered as an alternative to opioids for ED short-term pain control."	8.98	A Systematic Review and Meta-analysis of Ketamine as an Alternative to Opioids for Acute Pain in the Emergency Department. ( Carpenter, CR; Colditz, GA; Doering, M; Karlow, N; Miller, J; Motov, S; Schlaepfer, CH; Schwarz, ES; Stoll, CRT, 2018)
"A short cut review was carried out to establish whether low-dose ketamine is better than morphine at safely and effectively reducing pain scores in ED patients with acute pain who do not respond to conventional therapies."	8.93	BET 2: Low-dose ketamine for acute pain in the ED. ( Duncan, C; Riley, B, 2016)
"Subdissociative-dose ketamine (low-dose ketamine) is effective and safe to use alone or in combination with opioid analgesics for the treatment of acute pain in the ED."	8.93	Is There a Role for Intravenous Subdissociative-Dose Ketamine Administered as an Adjunct to Opioids or as a Single Agent for Acute Pain Management in the Emergency Department? ( Motov, S; Nakajima, Y; Rosenbaum, S; Vilke, GM, 2016)
"This multi-center, retrospective cohort study evaluated adult patients who received analgesic and sub-dissociative dose ketamine for the management of acute pain between May 5, 2018, and August 30, 2021, in 21 emergency departments at academic, community, and critical access hospitals across four states."	8.31	Efficacy of analgesic and sub-dissociative dose ketamine for acute pain in the emergency department. ( Beaudrie-Nunn, AN; Bellolio, F; Canterbury, EA; Mara, KC; Wieruszewski, ED; Woods, EJ, 2023)
"A subanesthetic intravenous ketamine infusion is a safe and effective acute pain management modality for moderate to severely painful surgical procedures and may be useful in patients who are at increased risk for opioid-related adverse events."	8.31	Implementing an intravenous ketamine protocol for acute pain in the medical-surgical setting. ( Fretwell, D; Hunter, OO; Lu, A; Mariano, ER, 2023)
"Ketamine is known for its antinociceptive effect and is also used for treatment-resistant depression."	8.31	Intranasal (2R, 6R)-hydroxynorketamine for acute pain: Behavioural and neurophysiological safety analysis in mice. ( Aleem, M; Goswami, N; Manda, K, 2023)
"Managing severe acute nociceptive pain in buprenorphine-maintained individuals for opioid use disorder management is challenging owing to the high affinity and very slow dissociation of buprenorphine from μ-opioid receptors that hinders the use of full agonist opioid analgesics."	7.96	Efficacy of multimodal analgesic treatment of severe traumatic acute pain in mice pretreated with chronic high dose of buprenorphine inducing mechanical allodynia. ( Bounes, V; Coutens, B; Derreumaux, C; Frances, B; Guiard, BP; Labaste, F; Minville, V; Moulédous, L; Roussin, A, 2020)
"Ketamine infusions have been used for decades to treat acute pain, but a recent surge in usage has made the infusions a mainstay of treatment in emergency departments, in the perioperative period in individuals with refractory pain, and in opioid-tolerant patients."	7.88	Consensus Guidelines on the Use of Intravenous Ketamine Infusions for Acute Pain Management From the American Society of Regional Anesthesia and Pain Medicine, the American Academy of Pain Medicine, and the American Society of Anesthesiologists. ( Bhatia, A; Buvanendran, A; Cohen, SP; Davis, FN; Hooten, WM; Hurley, RW; Narouze, S; Schwenk, ES; Viscusi, ER; Wasan, AD, 2018)
"Before updating the French guidelines on postoperative pain treatment in 2015, the Pain Committee of the French Society of Anaesthesiology and Intensive Care (SFAR) conducted a survey on the medical use of ketamine in France."	7.81	Ketamine for pain management in France, an observational survey. ( Beloeil, H; Derivaux, B; Martinez, V, 2015)
"Rib fractures are associated with increased mortality, particularly in the elderly."	6.90	Ketamine infusion for pain control in elderly patients with multiple rib fractures: Results of a randomized controlled trial. ( Boyle, K; Carver, TW; Drescher, KM; Juul, J; Kugler, NW; Paul, JS; Peppard, WJ; Rein, L; Somberg, LB; Szabo, A, 2019)
" We hypothesized that low-dose ketamine, compared to placebo, as an adjunctive treatment to opioids would result in better pain control over 2 hours and greater patient satisfaction with pain control; further, this protocol will result in a lower opioid dosage over 2 hours."	6.84	Ketamine as an Adjunct to Opioids for Acute Pain in the Emergency Department: A Randomized Controlled Trial. ( Bowers, KJ; Heitz, C; McAllister, KB; Ray, M, 2017)
"In 12 healthy male volunteers the effect of rifampicin versus placebo pretreatment on S-ketamine-induced analgesia and cognition was quantified; the S-ketamine dosage was 20 mg/h for 2 h."	6.77	Estimation of the contribution of norketamine to ketamine-induced acute pain relief and neurocognitive impairment in healthy volunteers. ( Aarts, L; Dahan, A; Kharasch, E; Niesters, M; Noppers, I; Olofsen, E; Sarton, E, 2012)
"Ketamine was compared with various opioids given alone, and intranasal ketamine given with nitrous oxide was compared with nitrous oxide given alone."	6.66	Ketamine for the treatment of prehospital acute pain: a systematic review of benefit and harm. ( Dahl Friesgaard, K; Hyldmo, PK; Kongstad, P; Kurola, J; Larsen, R; Magnusson, V; Raatiniemi, L; Rehn, M; Rognås, L; Sandberg, M; Vist, GE, 2020)
"Ketamine is an old anesthetic agent that relieves pain by reducing central sensitization in the central nervous system."	6.55	Ketamine in the treatment of acute pain. ( Brinck, E; Kontinen, V, 2017)
" Predefined subgroup analyses and meta-regression did not detect significant differences across subgroups, including a dose-response relationship."	6.53	Ketamine added to morphine or hydromorphone patient-controlled analgesia for acute postoperative pain in adults: a systematic review and meta-analysis of randomized trials. ( Cheng, D; Johnston, B; Kaushal, A; Martin, J; Wang, L; Zhu, F, 2016)
"Ketamine is a well-known anesthetic with its use trailing back to the 1960s."	6.52	The use of subdissociative-dose ketamine for acute pain in the emergency department. ( Motov, SM; Sin, B; Ternas, T, 2015)
"To compare the analgesic efficacy of ultrasound-guided selective peripheral nerve block (PNB) and sub-dissociative dose ketamine (SDK) for management of acute pain in patients with extremity injuries presenting to the emergency department (ED)."	5.69	Ultrasound-guided selective peripheral nerve block compared with the sub-dissociative dose of ketamine for analgesia in patients with extremity injuries. ( Behera, SHP; Hansda, U; Mishra, TS; Mohanty, CR; Panda, R; Radhakrishnan, RV; Sahoo, S; Shaji, IM; Topno, N; Varghese, JJ, 2023)
"ketamine has potential advantages over morphine for musculoskeletal pain relief."	5.51	Non-inferiority of intranasal ketamine compared to intravenous morphine for musculoskeletal pain relief among older adults in an emergency department: a randomised controlled trial. ( Paksophis, T; Sri-On, J; Thong-On, K; Tongbua, S, 2022)
"A short cut review was carried out to establish whether low-dose ketamine is a safe and effective alternative to opioids in ED patients in acute severe pain."	5.51	BET 2: Safety and efficacy of low-dose ketamine versus opioids for acute pain management in the ED. ( AlSagre, A; BinKharfi, M, 2019)
"The purpose of this study is to investigate if an orally administered combination of aspirin and ketamine will provide better analgesia than a ketamine alone in adult patients presenting to the Emergency Department (ED) with acute musculoskeletal pain."	5.51	Oral Aspirin/ketamine versus oral ketamine for emergency department patients with acute musculoskeletal pain. ( Barberan, C; Correa Bravo, S; Davis, A; Drapkin, J; Fassassi, C; Gerges, L; Gohel, A; Hossain, R; Likourezos, A; Motov, S; Niceforo, P; Silver, M, 2022)
" S(+)-ketamine is an N-methyl-D-aspartic acid (NMDA) receptor antagonist with a strong analgesic effect and can significantly relieve postoperative acute pain and reduce opioid consumption."	5.51	Evaluation of the effect of perioperative administration of S(+)-ketamine hydrochloride injection for postoperative acute pain in children: study protocol for a prospective, multicenter, randomized, open-label, parallel-group, pragmatic clinical trial. ( Chen, P; Duan, C; Lan, C; Mi, W; Qu, S; Sun, Y; Wang, H; Yang, L; Zhang, J; Zhou, L, 2022)
"The Ketamine for Acute Pain Management After Trauma (KAPT) with registration # NCT04129086 was registered on October 16, 2019."	5.51	Ketamine for acute pain after trauma: the KAPT randomized controlled trial. ( Balogh, J; Green, C; Harvin, JA; Kao, LS; Klugh, J; Prater, SJ; Puzio, TJ; Sergot, PB; Stephens, CT; Wade, CE; Wandling, MW, 2022)
" The primary objective of this pilot study is to determine if multiple dosing over a three-day perioperative period with oral ketamine is a safe treatment method for acute pain after amputation surgery."	5.48	Oral Ketamine for Acute Pain Management After Amputation Surgery. ( Buvanendran, A; Kroin, JS; Moric, M; Rajagopal, A; Robison, SJ; Tuman, KJ, 2018)
" This study aims to evaluate the use of topical ketamine in acute pain reduction by directly comparing it to lidocaine-prilocaine (EMLA) cream."	5.41	Topical ketamine as a local anesthetic agent in reducing venipuncture pain: A randomized controlled trial. ( Golshani, K; Heydari, F; Khalilian, S; Majidinejad, S; Masoumi, B; Massoumi, A, 2021)
"3 mg/kg over 15 min provides analgesic efficacy comparable to morphine for short-term treatment of acute pain in the geriatric ED patients but results in higher rates of psychoperceptual adverse effects."	5.30	Intravenous subdissociative-dose ketamine versus morphine for acute geriatric pain in the Emergency Department: A randomized controlled trial. ( Brady, J; Butt, M; Drapkin, J; Flom, P; Fromm, C; Gohel, A; Likourezos, A; Mai, M; Mann, S; Marshall, J; Motov, S; Rothberger, N; Yetter, E, 2019)
"Given that combinations of morphine with low doses of ketamine in patients with renal colic pain causes more pain and morphine consumption reduction then this combination is suggested as an alternative treatment that could be utilized in patients with renal colic."	5.27	Can low-dose of ketamine reduce the need for morphine in renal colic? A double-blind randomized clinical trial. ( Abbasi, S; Bidi, N; Farsi, D; Hafezimoghadam, P; Mahshidfar, B; Mofidi, M; Rezai, M, 2018)
"Ketamine PCA led to lower cumulative opioid consumption and lower oxygen supplementation requirements, though hallucinations occurred more frequently with use of ketamine."	5.27	Ketamine versus hydromorphone patient-controlled analgesia for acute pain in trauma patients. ( Branson, RD; Droege, CA; Droege, ME; Ernst, N; Gerlach, TW; Johannigman, JA; Mueller, EW; Robinson, BRH; Takieddine, SC; Webb, M, 2018)
" Although low-dose ketamine demonstrates analgesic efficacy for acute pain complaints in the ED, headaches have historically been excluded from these trials."	5.27	Low-dose Ketamine Does Not Improve Migraine in the Emergency Department: A Randomized Placebo-controlled Trial. ( Bos, L; Etchison, AR; Heitz, C; McAllister, KB; Mohammed, M; Park, B; Phan, AV; Ray, M, 2018)
"5 μg/kg intranasal fentanyl in children 4 to 17 years old with acute pain from suspected isolated extremity fractures presenting to an urban Level II pediatric trauma center from December 2015 to November 2016."	5.24	Randomized Controlled Feasibility Trial of Intranasal Ketamine Compared to Intranasal Fentanyl for Analgesia in Children with Suspected Extremity Fractures. ( Bryant, KK; Dunn, C; Hogg, M; Moore, CG; Reynolds, SL; Runyon, MS; Studnek, JR; Templin, MA; Walker, KR; Young, JR, 2017)
"Compare adverse effects and analgesic efficacy of low-dose ketamine for acute pain in the ED administered either by single intravenous push (IVP) or short infusion (SI)."	5.24	A prospective randomized, double-dummy trial comparing IV push low dose ketamine to short infusion of low dose ketamine for treatment of pain in the ED. ( Brady, J; Drapkin, J; Fromm, C; Homel, P; Likourezos, A; Mai, M; Motov, S; Pushkar, I; Yasavolian, M, 2017)
" The evidence generated by this study is that ketamine is non-inferior to opioids (morphine and fentanyl) in controlling acute pain in children."	5.22	The Effectiveness of Ketamine Compared to Opioid Analgesics for management of acute pain in Children in The Emergency Department: systematic Review. ( Alanazi, E, 2022)
"Primary outcomes were postoperative acute pain at rest/during movement after 24 h and number of patients with ketamine-related adverse events."	5.22	Perioperative ketamine for postoperative pain management in patients with preoperative opioid intake: A systematic review and meta-analysis. ( Kranke, P; Lipke, E; Meyer-Frießem, CH; Pogatzki-Zahn, EM; Reichl, S; Schnabel, A; Weibel, S; Zahn, PK, 2022)
"3 mg/kg provides analgesic effectiveness and apparent safety comparable to that of intravenous morphine for short-term treatment of acute pain in the ED."	5.20	Intravenous Subdissociative-Dose Ketamine Versus Morphine for Analgesia in the Emergency Department: A Randomized Controlled Trial. ( Cohen, V; Fromm, C; Homel, P; Likourezos, A; McKay, C; Motov, S; Pushkar, I; Rockoff, B; Soleyman-Zomalan, E; Terentiev, V, 2015)
"Low-dose ketamine combined with a reduced dose hydromorphone protocol produced rapid, profound pain relief without significant side effects in a diverse cohort of ED patients with acute pain."	5.17	Effective analgesia with low-dose ketamine and reduced dose hydromorphone in ED patients with severe pain. ( Ahern, TL; Frazee, BW; Herring, AA; Stone, MB, 2013)
"To assess the efficacy and safety of intranasal analgesic-dose ketamine as compared to intranasal fentanyl for pediatric acute pain."	5.05	Intranasal ketamine for acute pain management in children: A systematic review and meta-analysis. ( Anderson, JL; Bellolio, F; Homme, JL; Lee, JY; Oliveira J E Silva, L, 2020)
"Ketamine is noninferior to morphine for the control of acute pain, indicating that ketamine can be considered as an alternative to opioids for ED short-term pain control."	4.98	A Systematic Review and Meta-analysis of Ketamine as an Alternative to Opioids for Acute Pain in the Emergency Department. ( Carpenter, CR; Colditz, GA; Doering, M; Karlow, N; Miller, J; Motov, S; Schlaepfer, CH; Schwarz, ES; Stoll, CRT, 2018)
"To evaluate the efficacy and safety of perioperative intravenous ketamine in adult patients when used for the treatment or prevention of acute pain following general anaesthesia."	4.98	Perioperative intravenous ketamine for acute postoperative pain in adults. ( Bell, RF; Brinck, EC; Heesen, M; Kontinen, V; Moore, RA; Straube, S; Tiippana, E, 2018)
"The aim of the study is to determine the performance of low-dose ketamine (LDK) as an analgesic for acute pain management in adult patients in the emergency department (ED)."	4.98	Systematic review of the use of low-dose ketamine for analgesia in the emergency department. ( Clark, E; Ghate, G; Vaillancourt, C, 2018)
"A short cut review was carried out to establish whether low-dose ketamine is better than morphine at safely and effectively reducing pain scores in ED patients with acute pain who do not respond to conventional therapies."	4.93	BET 2: Low-dose ketamine for acute pain in the ED. ( Duncan, C; Riley, B, 2016)
"Ketamine is known for its antinociceptive effect and is also used for treatment-resistant depression."	4.31	Intranasal (2R, 6R)-hydroxynorketamine for acute pain: Behavioural and neurophysiological safety analysis in mice. ( Aleem, M; Goswami, N; Manda, K, 2023)
"This multi-center, retrospective cohort study evaluated adult patients who received analgesic and sub-dissociative dose ketamine for the management of acute pain between May 5, 2018, and August 30, 2021, in 21 emergency departments at academic, community, and critical access hospitals across four states."	4.31	Efficacy of analgesic and sub-dissociative dose ketamine for acute pain in the emergency department. ( Beaudrie-Nunn, AN; Bellolio, F; Canterbury, EA; Mara, KC; Wieruszewski, ED; Woods, EJ, 2023)
"Ketamine, adverse effects, tachycardia, hypertension, postoperative pain, chronic postsurgical pain."	4.31	Effect of Analgesic Low-Dose Ketamine Infusions on the Cardiovascular Response: A Retrospective Analysis. ( Cadavid, AM; Calle, E; Camelo, JE; Casas, FD; Ramirez, CD; Tovar, A; Visbal, K, 2023)
" The acute pain group did not show an opioid reduction associated with the ketamine infusions."	4.12	Low-dose ketamine infusions reduce opioid use in pediatric and young adult oncology patients. ( Anghelescu, DL; Li, Y; Morgan, KJ; Patni, T; Ryan, S; Wu, D, 2022)
"Managing severe acute nociceptive pain in buprenorphine-maintained individuals for opioid use disorder management is challenging owing to the high affinity and very slow dissociation of buprenorphine from μ-opioid receptors that hinders the use of full agonist opioid analgesics."	3.96	Efficacy of multimodal analgesic treatment of severe traumatic acute pain in mice pretreated with chronic high dose of buprenorphine inducing mechanical allodynia. ( Bounes, V; Coutens, B; Derreumaux, C; Frances, B; Guiard, BP; Labaste, F; Minville, V; Moulédous, L; Roussin, A, 2020)
"Guidelines issued by the American Society of Regional Anesthesia and Pain Medicine suggest that ketamine infusions for acute pain management are advantageous as a primary treatment or as an opioid adjunct."	3.91	Subanesthetic ketamine infusions for the management of pediatric pain in non-critical care settings: An observational analysis. ( Fernandez, PG; Lee, J; Masaracchia, MM; Sites, BD; Thomas, JJ, 2019)
"Before updating the French guidelines on postoperative pain treatment in 2015, the Pain Committee of the French Society of Anaesthesiology and Intensive Care (SFAR) conducted a survey on the medical use of ketamine in France."	3.81	Ketamine for pain management in France, an observational survey. ( Beloeil, H; Derivaux, B; Martinez, V, 2015)
"Unit medical protocols authorize ketamine for tourniquet pain, amputations, long-bone fractures, and pain refractory to other agents."	3.80	Prehospital analgesia with ketamine for combat wounds: a case series. ( Conklin, CC; Fisher, AD; Mabry, RL; Rippee, B; Shehan, H, 2014)
"The data suggest that the combination of metoclopramide and ketamine synergistically controls acute pain in mice."	3.78	Antinociception by metoclopramide, ketamine and their combinations in mice. ( Al-Baggou, BKh; Mohammad, FK; Naser, AS, 2012)
"We aimed to assess and compare the analgesic efficacies and adverse effects of ketamine administered through a breath-actuated nebulizer at 3 different dosing regimens for emergency department patients presenting with acute and chronic painful conditions."	3.01	Comparison of Nebulized Ketamine at Three Different Dosing Regimens for Treating Painful Conditions in the Emergency Department: A Prospective, Randomized, Double-Blind Clinical Trial. ( Butt, M; Davis, A; Dove, D; Drapkin, J; Fassassi, C; Favale, P; Gohel, A; Hossain, R; Kabariti, S; Likourezos, A; Marshall, J; Motov, S; Silver, M, 2021)
"Ketamine has the optimal characteristics for use in an Emergency Department."	3.01	[Ketamine for medically-delegated analgesia in the Emergency Department]. ( Della Santa, V; Heymann, EP; Jardot, F; Petreska, I, 2023)
"Rib fractures are associated with increased mortality, particularly in the elderly."	2.90	Ketamine infusion for pain control in elderly patients with multiple rib fractures: Results of a randomized controlled trial. ( Boyle, K; Carver, TW; Drescher, KM; Juul, J; Kugler, NW; Paul, JS; Peppard, WJ; Rein, L; Somberg, LB; Szabo, A, 2019)
"Acute pain is a common condition among prehospital patients and prompt management is pivotal."	2.87	Is intravenously administered, subdissociative-dose KETAmine non-inferior to MORPHine for prehospital analgesia (the KETAMORPH study): study protocol for a randomized controlled trial. ( Auffret, Y; Brenckmann, V; Broch, H; Deciron, F; Ecoffey, C; Fradin, P; Hardouin, JB; Javaudin, F; Jenvrin, J; Kabbaj, A; Lariby, S; Le Bastard, Q; Le Cornec, C; Le Pottier, M; Longo, C; Montassier, E, 2018)
"Ketamine is an effective and safe multimodal analgesic in patients undergoing breast surgery, administered both intravenously and when added to bupivacaine in paravertebral blocks."	2.72	The Effect of Ketamine on Acute and Chronic Wound Pain in Patients Undergoing Breast Surgery: A Meta-Analysis and Systematic Review. ( Bi, Y; Liu, B; Ma, J; Ye, Y; Zhang, X; Zhu, Y, 2021)
" Predefined subgroup analyses and meta-regression did not detect significant differences across subgroups, including a dose-response relationship."	2.53	Ketamine added to morphine or hydromorphone patient-controlled analgesia for acute postoperative pain in adults: a systematic review and meta-analysis of randomized trials. ( Cheng, D; Johnston, B; Kaushal, A; Martin, J; Wang, L; Zhu, F, 2016)
"Ketamine is a well-known anesthetic with its use trailing back to the 1960s."	2.52	The use of subdissociative-dose ketamine for acute pain in the emergency department. ( Motov, SM; Sin, B; Ternas, T, 2015)
"Recent awareness that chronic pain may occur after childbirth has prompted clinicians and researchers to investigate this topic."	2.49	Chronic pain after childbirth. ( Bollag, L; Landau, R; Ortner, C, 2013)
"The aim of this study is to assess the current situation in out of hospital pain management in Germany regarding the substances, indications, dosage and the delegation of the use of analgesics to emergency medical service (EMS) staff."	1.91	Application of analgesics in emergency services in Germany: a survey of the medical directors. ( Scharonow, M; Scharonow, O; Vilcane, S; Weilbach, C, 2023)
"Currently, the treatment of SCD acute pain only targets its symptoms, rather than underlying mechanisms, and is directed by expert and consensus guidelines."	1.72	Subanesthetic ketamine: the way forward for pain management in sickle cell disease patients? ( Carullo, V; Nobrega, R; Quezado, ZMN; Thein, SL, 2022)
"Acetaminophen was mixed with all 18 solutions and was examined at time 0, 15, 30, and 60 min."	1.72	Compatibility of intravenous acetaminophen with morphine, fentanyl and ketamine in acute pediatric pain setting. ( Chan, MTV; Cheaib, A; O'Loughlin, E; Peng, YG; Williams, R, 2022)
"Ketamine is a noncompetitive N-methyl-D-aspartate/glutamate receptor complex antagonist that decreases pain by diminishing central sensitization and hyperalgesia."	1.62	Nebulized Ketamine Used for Pain Management of Orthopedic Trauma. ( Davis, AR; Dove, D; Fassassi, C; Khordipour, E; Motov, S; Ranginwala, A, 2021)
"Fentanyl was most frequently used for APT (n = 19)."	1.51	Intranasal Analgesia and Sedation in Pediatric Emergency Care-A Prospective Observational Study on the Implementation of an Institutional Protocol in a Tertiary Children's Hospital. ( Bantel, C; Eich, C; Fieler, M; Jacobsen, N; Nemeth, M; Sümpelmann, R, 2019)
" The primary objective of this pilot study is to determine if multiple dosing over a three-day perioperative period with oral ketamine is a safe treatment method for acute pain after amputation surgery."	1.48	Oral Ketamine for Acute Pain Management After Amputation Surgery. ( Buvanendran, A; Kroin, JS; Moric, M; Rajagopal, A; Robison, SJ; Tuman, KJ, 2018)

Research

Studies (96)

Authors

Clinical Trials (46)

Trial Overview

Trial Outcomes

Reduction in Pain Score at 60 Minutes

Timeframe	Studies, this research(%)	All Research%
pre-1990	0 (0.00)	18.7374
1990's	0 (0.00)	18.2507
2000's	0 (0.00)	29.6817
2010's	55 (57.29)	24.3611
2020's	41 (42.71)	2.80

Authors	Studies
Silverstein, WK	1
Juurlink, DN	1
Zipursky, JS	1
Lindbeck, G	1
Shah, MI	1
Braithwaite, S	1
Powell, JR	1
Panchal, AR	1
Browne, LR	1
Lang, ES	1
Burton, B	1
Coughenour, J	1
Crowe, RP	1
Degn, H	1
Hedges, M	1
Gasper, J	1
Guild, K	1
Mattera, C	1
Nasca, S	1
Taillac, P	1
Warth, M	1
Meyer-Frießem, CH	1
Lipke, E	1
Weibel, S	1
Kranke, P	1
Reichl, S	1
Pogatzki-Zahn, EM	1
Zahn, PK	1
Schnabel, A	1
Moradi, MM	2
Safaie, A	1
Baratloo, A	1
Payandemehr, P	1
Tongbua, S	1
Sri-On, J	1
Thong-On, K	1
Paksophis, T	1
Anghelescu, DL	2
Ryan, S	1
Wu, D	1
Morgan, KJ	2
Patni, T	1
Li, Y	1
O'Loughlin, E	1
Peng, YG	1
Cheaib, A	1
Chan, MTV	1
Williams, R	1
Davis, A	3
Fassassi, C	4
Dove, D	3
Drapkin, J	5
Likourezos, A	6
Gohel, A	4
Favale, P	2
Hossain, R	3
Butt, M	3
Gerges, L	2
Motov, S	10
Kenney, MO	1
Becerra, B	1
Mallikarjunan, A	1
Shah, N	1
Smith, WR	1
Barberan, C	1
Correa Bravo, S	1
Silver, M	2
Niceforo, P	1
Wang, H	1
Duan, C	1
Zhang, J	1
Qu, S	1
Sun, Y	1
Zhou, L	1
Yang, L	1
Lan, C	1
Mi, W	1
Chen, P	1
Puzio, TJ	1
Klugh, J	1
Wandling, MW	1
Green, C	1
Balogh, J	1
Prater, SJ	1
Stephens, CT	1
Sergot, PB	1
Wade, CE	1
Kao, LS	1
Harvin, JA	1
Alanazi, E	1
Nobrega, R	1
Carullo, V	1
Thein, SL	1
Quezado, ZMN	1
Mohanty, CR	1
Varghese, JJ	1
Panda, R	1
Sahoo, S	1
Mishra, TS	1
Radhakrishnan, RV	1
Topno, N	1
Hansda, U	1
Shaji, IM	1
Behera, SHP	1
Hunter, OO	1
Lu, A	1
Fretwell, D	1
Mariano, ER	1
Goswami, N	1
Aleem, M	1
Manda, K	1
Fjendbo Galili, S	1
Nikolajsen, L	1
Papadomanolakis-Pakis, N	1
Ying, M	1
Zuo, Y	1
Beaudrie-Nunn, AN	1
Wieruszewski, ED	1
Woods, EJ	1
Bellolio, F	2
Mara, KC	1
Canterbury, EA	1
Vilcane, S	1
Scharonow, O	1
Weilbach, C	1
Scharonow, M	1
Cadavid, AM	1
Casas, FD	1
Camelo, JE	1
Tovar, A	1
Ramirez, CD	1
Calle, E	1
Visbal, K	1
Jardot, F	1
Petreska, I	1
Della Santa, V	1
Heymann, EP	1
Michelet, F	1
Smyth, M	1
Lall, R	1
Noordali, H	1
Starr, K	1
Berridge, L	1
Yeung, J	1
Fuller, G	1
Petrou, S	1
Walker, A	1
Mark, J	1
Canaway, A	1
Khan, K	1
Perkins, GD	1
Kugler, NW	2
Carver, TW	2
Juul, J	2
Peppard, WJ	2
Boyle, K	1
Drescher, KM	2
Szabo, A	2
Rein, L	1
Somberg, LB	2
Paul, JS	2
Coutens, B	1
Derreumaux, C	1
Labaste, F	1
Minville, V	1
Guiard, BP	1
Moulédous, L	1
Bounes, V	1
Roussin, A	1
Frances, B	1
Savage, T	1
Polsky, Z	1
Ross, M	1
Bouida, W	1
Bel Haj Ali, K	1
Ben Soltane, H	1
Msolli, MA	1
Boubaker, H	1
Sekma, A	1
Beltaief, K	1
Grissa, MH	1
Methamem, M	1
Boukef, R	1
Belguith, A	1
Nouira, S	1
Ferguson, CL	1
Beckett, RD	1
Oliveira J E Silva, L	1
Lee, JY	1
Homme, JL	1
Anderson, JL	1
Balzer, N	1
McLeod, SL	1
Walsh, C	1
Grewal, K	1
Bi, Y	1
Ye, Y	1
Zhu, Y	1
Ma, J	1
Zhang, X	1
Liu, B	1
Sandberg, M	1
Hyldmo, PK	1
Kongstad, P	1
Dahl Friesgaard, K	1
Raatiniemi, L	1
Larsen, R	1
Magnusson, V	1
Rognås, L	1
Kurola, J	1
Rehn, M	1
Vist, GE	1
Davis, AR	1
Ranginwala, A	1
Khordipour, E	1
Lovett, S	1
Reed, T	1
Riggs, R	1
Lew, G	1
Koch, E	1
Durazo-Arvizu, RA	1
Rech, MA	1
Rocchio, RJ	1
Ward, KE	1
Li, C	1
Doellner, C	1
Leis, A	1
Marinkovic, A	1
Gibbons, K	1
Wagner, D	1
Heydari, F	1
Khalilian, S	1
Golshani, K	1
Majidinejad, S	1
Masoumi, B	1
Massoumi, A	1
Li, X	1
Hua, GC	1
Peng, F	1
Kabariti, S	1
Marshall, J	2
Chong, CC	1
Schug, SA	1
Alshahrani, MS	2
AlSulaibikh, AH	1
ElTahan, MR	1
AlFaraj, SZ	1
Asonto, LP	2
AlMulhim, AA	1
AlAbbad, MF	1
Almaghraby, N	2
AlJumaan, MA	1
AlJunaid, TO	1
Darweesh, MN	1
AlHawaj, FM	1
Mahmoud, AM	2
Alossaimi, BK	2
Alotaibi, SK	2
AlMutairi, TM	2
AlSulaiman PharmD, DA	1
Alfaraj, D	2
Alhawwas, R	1
Mbuagbaw, L	1
Lewis, K	1
Verhovsek, M	1
Crowther, M	1
Guyatt, G	1
Alhazzani, W	2
Ghate, G	1
Clark, E	1
Vaillancourt, C	1
Abbasi, S	1
Bidi, N	1
Mahshidfar, B	1
Hafezimoghadam, P	1
Rezai, M	1
Mofidi, M	1
Farsi, D	1
Reynolds, SL	1
Bryant, KK	1
Studnek, JR	1
Hogg, M	1
Dunn, C	1
Templin, MA	1
Moore, CG	1
Young, JR	1
Walker, KR	1
Runyon, MS	1
Buvanendran, A	2
Kroin, JS	1
Rajagopal, A	1
Robison, SJ	1
Moric, M	1
Tuman, KJ	1
Brinck, E	1
Kontinen, V	2
Takieddine, SC	1
Droege, CA	1
Ernst, N	1
Droege, ME	1
Webb, M	1
Branson, RD	1
Gerlach, TW	1
Robinson, BRH	1
Johannigman, JA	1
Mueller, EW	1
Le Cornec, C	1
Lariby, S	1
Brenckmann, V	1
Hardouin, JB	1
Ecoffey, C	1
Le Pottier, M	1
Fradin, P	1
Broch, H	1
Kabbaj, A	1
Auffret, Y	1
Deciron, F	1
Longo, C	1
Javaudin, F	1
Le Bastard, Q	1
Jenvrin, J	1
Montassier, E	1
Weingarten, TN	1
Taenzer, AH	1
Elkassabany, NM	1
Le Wendling, L	1
Nin, O	1
Kent, ML	1
Lubega, FA	1
DeSilva, MS	1
Munube, D	1
Nkwine, R	1
Tumukunde, J	1
Agaba, PK	1
Nabukenya, MT	1
Bulamba, F	1
Luggya, TS	1
Mann, S	1
Yetter, E	1
Brady, J	2
Rothberger, N	1
Flom, P	1
Mai, M	2
Fromm, C	3
Schwenk, ES	1
Viscusi, ER	1
Hurley, RW	1
Wasan, AD	1
Narouze, S	1
Bhatia, A	1
Davis, FN	1
Hooten, WM	1
Cohen, SP	1
Breivik, H	1
Zeballos, JL	1
Lirk, P	1
Rathmell, JP	1
Karlow, N	1
Schlaepfer, CH	1
Stoll, CRT	1
Doering, M	1
Carpenter, CR	1
Colditz, GA	1
Miller, J	1
Schwarz, ES	1
Yin, Z	1
Etchison, AR	1
Bos, L	1
Ray, M	2
McAllister, KB	2
Mohammed, M	1
Park, B	1
Phan, AV	1
Heitz, C	3
Morgenstern, J	1
Bond, C	1
Milne, WK	1
Brinck, EC	1
Tiippana, E	1
Heesen, M	1
Bell, RF	1
Straube, S	1
Moore, RA	1
BinKharfi, M	1
AlSagre, A	1
Davison, SN	1
Thompson, T	1
Whiter, F	1
Gallop, K	1
Veronese, N	1
Solmi, M	1
Newton, P	1
Stubbs, B	1
Andolfatto, G	1
Innes, K	1
Dick, W	1
Jenneson, S	1
Willman, E	1
Stenstrom, R	1
Zed, PJ	1
Benoit, G	1
El Tahan, MM	1
Al Sulaibikh, AH	1
Al Faraj, SZ	1
Al Mulhim, AA	1
Al Abbad, MF	1
Al Nahhash, SA	1
Aldarweesh, MN	1
Al Jumaan, MA	1
Al Junaid, TO	1
Al Hawaj, FM	1
AlKenany, S	1
ElSayed, OF	1
Abdelwahab, HM	1
Moussa, MM	1
AlSulaiman, DA	1
Al Shahrani, SD	1
Puri, L	1
Masaracchia, MM	1
Sites, BD	1
Lee, J	1
Thomas, JJ	1
Fernandez, PG	1
Landau, R	1
Bollag, L	1
Ortner, C	1
Ahern, TL	2
Herring, AA	2
Stone, MB	1
Frazee, BW	2
Jennings, CA	1
Bobb, BT	1
Noreika, DM	1
Coyne, PJ	1
Vaid, P	1
McCartney, CJ	1
Nelligan, K	1
Russell, KW	1
Scaife, CL	1
Weber, DC	1
Windsor, JS	1
Wheeler, AR	1
Smith, W	1
Wedmore, I	1
McIntosh, SE	1
Lieberman, JR	1
Beaudoin, FL	1
Lin, C	1
Guan, W	1
Merchant, RC	1
Fisher, AD	1
Rippee, B	1
Shehan, H	1
Conklin, CC	1
Mabry, RL	1
Goltser, A	1
Soleyman-Zomalan, E	2
Kresch, F	1
Anderson, ES	1
Madia, VA	1
Fahimi, J	1
Miller, JP	1
Schauer, SG	1
Ganem, VJ	1
Bebarta, VS	1
Sin, B	1
Ternas, T	1
Motov, SM	2
Rockoff, B	1
Cohen, V	1
Pushkar, I	2
McKay, C	1
Homel, P	2
Terentiev, V	1
Yetim, M	1
Tekindur, S	1
Eyi, YE	1
Barrett, TW	1
Schriger, DL	1
Banting, J	1
Beriano, T	1
Radvansky, BM	1
Shah, K	1
Parikh, A	1
Sifonios, AN	1
Le, V	1
Eloy, JD	1
Martinez, V	1
Derivaux, B	1
Beloeil, H	1
Wang, L	1
Johnston, B	1
Kaushal, A	1
Cheng, D	1
Zhu, F	1
Martin, J	1
Nelson, LS	1
Badiola, IJ	1
Rosenbaum, S	1
Vilke, GM	1

Trial	Phase	Enrollment	Study Type	Start Date	Status
Analgesic Efficacy of Orally Administered VTS-K (Liquid Oral Ketamine Taken Simultaneously With VTS-Aspirin) for Pain Management of Adult ED Patients Presenting to the ED With Acute Musculoskeletal Pain[NCT04702555]		25 participants (Actual)	Observational	2021-01-08	Completed
A Comparison of Proprietary Formulations of Oral Ketamine + Aspirin and Oral Ketamine Alone in Adult Patients Presenting to the ED With Acute Musculoskeletal Pain: Prospective, Randomized, Open-Label, Clinical Trial.[NCT04860804]	Phase 4	60 participants (Actual)	Interventional	2021-04-22	Completed
Safety and Efficacy Evaluation of S (+) -Ketamine for Postoperative Acute Pain in Children in Perioperative Settings: A Multicenter, Randomized, Open-label, Active Controlled Pragmatic Clinical Trial[NCT04834427]	Phase 4	3,000 participants (Anticipated)	Interventional	2021-05-01	Not yet recruiting
Ketamine for Acute Pain After Trauma: KAPT Trial[NCT04129086]	Phase 4	305 participants (Actual)	Interventional	2020-07-01	Completed
Paravertebral Block Versus Simultaneous Ketamine and Lidocaine Infusions for Pain Management in Rib Fracture Patients[NCT04413799]	Early Phase 1	170 participants (Anticipated)	Interventional	2020-09-01	Recruiting
Pilot Study: Ketamine for Acute Pain After Rattlesnake Envenomation[NCT05379179]	Phase 4	40 participants (Anticipated)	Interventional	2022-06-20	Enrolling by invitation
A Combination Study With Sub-Dissociative Ketamine and Fentanyl to Treat Moderate to Severe Pain in the Emergency Department[NCT03959852]	Phase 4	6 participants (Actual)	Interventional	2019-11-18	Terminated (stopped due to Residency completed.)
Comparison of Ketamine 0.1 mg/kg, 0.2 mg/kg, and 0.3 mg/kg Intravenous Doses for Acute Pain in the Emergency Department: A Prospective, Randomized, Double-blind, Active-controlled, Clinical Trial[NCT03896230]	Phase 4	11 participants (Actual)	Interventional	2019-05-03	Terminated (stopped due to Due to resource limitations the study was on hold and was then terminated.)
A Prospective, Open-Label Pilot Clinical Trial of Oral Ketamine for Acute Pain Management After Amputation Surgery[NCT02341963]	Phase 1	5 participants (Actual)	Interventional	2015-01-31	Terminated (stopped due to Recruitment issues)
Ketamine Patient-Controlled Analgesia for Acute Pain in Native Airway Multiple and Orthopedic Trauma Patients: A Randomized, Active Comparator, Blinded Trial[NCT02062879]	Phase 3	20 participants (Actual)	Interventional	2014-04-30	Terminated (stopped due to Withdrawals from study due to anticipated effects from study drugs)
Intravenous Subdissociative-dose Ketamine Versus Morphine for Prehospital Analgesia a Randomized Controlled Trial[NCT03236805]	Phase 3	285 participants (Actual)	Interventional	2017-11-23	Terminated (stopped due to 285 patients have recruited instead on 496 but we don't want to continue to prolonge the study. Analysis will be performed on the data we have.)
A Pilot Study of the Use of Oral Ketamine for Treatment of Vaso-Occlusive Pain in Adolescents and Young Adults[NCT05378555]	Phase 3	10 participants (Anticipated)	Interventional	2023-05-01	Recruiting
Low-dose Ketamine Versus Morphine for Severe Painful Sickle Cell Crises in Children at Mulago Hospital: A Randomised Controlled Trial[NCT02434939]	Phase 4	240 participants (Actual)	Interventional	2015-06-30	Completed
Low-Dose Ketamine Versus Morphine for Moderate to Severe Pain in the Emergency Department Geriatric Population: A Prospective, Randomized, Double-Blind Study.[NCT02673372]	Phase 4	60 participants (Actual)	Interventional	2016-04-30	Completed
Ketamine for Refractory Chronic Migraine: a Pilot Study[NCT03896256]	Early Phase 1	6 participants (Actual)	Interventional	2019-03-22	Completed
The Effect of Low-dose of S-ketamine Combined With Sufentanil for Postoperative Patient-controlled Intravenous Analgesia in Patients Following Cesarean Section[NCT05299866]	Phase 4	216 participants (Anticipated)	Interventional	2022-04-12	Recruiting
Effect of Mini-dose Dexmedetomidine-Esketamine Infusion on Sleep Quality in Older Patients Undergoing Knee or Hip Replacement Surgery: A Multicenter Randomized Controlled Trial[NCT05950646]	Phase 4	154 participants (Anticipated)	Interventional	2023-11-01	Recruiting
The Effect of Intraoperative Lidocaine Infusion and Intraoperative Lidocaine Combined With Ketamine Infusion on Opioid Consumption After Laparoscopic Bariatric Surgery: A Randomized Controlled Trial[NCT04524130]	Phase 4	87 participants (Anticipated)	Interventional	2021-04-01	Active, not recruiting
(2R,6R)-Hydroxynorketamine a Novel Therapeutic Analgesic for the Treatment of Neuropathic Pain: A Randomized Double Blind Cross-Over Trial.[NCT05864053]	Phase 1/Phase 2	25 participants (Anticipated)	Interventional	2024-01-31	Not yet recruiting
Efficacy of Different Dose Esketamine and Dexmedetomidine Combination for Supplemental Analgesia After Scoliosis Correction Surgery: A Randomized, Double-blind Trial[NCT06062550]	Phase 4	312 participants (Anticipated)	Interventional	2023-10-31	Not yet recruiting
Impact of Different Dose Esketamine and Dexmedetomidine Combination for Supplemental Analgesia on Long-term Outcomes After Scoliosis Correction Surgery: Follow-up of a Randomized Trial[NCT06087510]	Phase 4	312 participants (Anticipated)	Interventional	2024-01-31	Not yet recruiting
The Effect and Contribution of a Perioperative Ketamine Infusion in an Established Enhanced Recovery Pathway[NCT04625283]	Phase 4	1,544 participants (Anticipated)	Interventional	2021-04-12	Enrolling by invitation
Patient Satisfaction With Subdissociative Dose Ketamine Versus Morphine for Emergency Department Pain Control[NCT04698772]		32 participants (Actual)	Observational	2019-12-19	Completed
Dexmedotomidine for Acute Pain Control in Patients With Multiple Rib Fractures[NCT05321121]	Phase 4	60 participants (Anticipated)	Interventional	2021-11-12	Recruiting
Ketamine Infusion Therapy for the Management of Acute Pain in Adult Rib Fracture Patients[NCT02432456]	Phase 4	153 participants (Actual)	Interventional	2015-09-30	Completed
Analgesic Effects of Low-dose S-ketamine in Patients Undergoing Major Spine Fusion Surgery: A Double-blinded, Randomized Controlled Trial[NCT04964219]	Phase 4	164 participants (Anticipated)	Interventional	2022-02-08	Recruiting
Low-dose S-ketamine and Dexmedetomidine in Combination With Opioids for Patient-controlled Analgesia After Scoliosis Correction Surgery: a Randomized, Double-blind, Placebo-controlled Trial[NCT04791059]	Phase 4	200 participants (Actual)	Interventional	2021-04-09	Completed
Observational Study of the Efficacy of Ketamine for Rescue Analgesia in the Post Anesthesia Recovery Room[NCT04701008]		143 participants (Actual)	Observational	2020-09-01	Completed
Prehospital Analgesia With Intra-Nasal Ketamine[NCT02753114]	Phase 4	120 participants (Actual)	Interventional	2017-11-06	Completed
Intranasal Ketamine Versus Subcutaneous Ketamine for Treatment of Post Traumatic Acute Pain in the Emergency Department[NCT05229055]	Phase 2/Phase 3	1,000 participants (Anticipated)	Interventional	2023-04-15	Recruiting
Ketamine for Acute Painful Crisis in Sickle Cell Disease Patients: Prospective Randomized Control Trial[NCT03431285]		264 participants (Anticipated)	Interventional	2018-01-01	Recruiting
Ketamine For Acute Treatment of Pain in Emergency Department[NCT02306759]	Phase 4	60 participants (Actual)	Interventional	2015-01-31	Completed
Comparing the Effectiveness of Low-dose Ketamine With Morphine to Treat Pain in Patients With Long Bone Fractures[NCT02430818]		13 participants (Actual)	Interventional	2015-04-30	Terminated (stopped due to were not able to enroll patients to a satisfactory level)
Low Dose Ketamine as an Adjunct to Opiates for Acute Pain in the Emergency Department[NCT02489630]	Phase 4	116 participants (Actual)	Interventional	2013-09-30	Completed
Adjuvant Low-dose Ketamine in Pediatric Sickle Cell Vaso-occlusive Crisis (AKTSS)[NCT03296345]	Phase 2	62 participants (Actual)	Interventional	2016-06-30	Completed
Ketamine Infusion for Acute Sickle Cell crisiS in the Emergency Department[NCT02417298]		12 participants (Actual)	Interventional	2015-11-30	Terminated (stopped due to Feasibility)
Opioid-Free Shoulder Arthroplasty[NCT03540030]	Phase 4	86 participants (Actual)	Interventional	2016-09-30	Completed
Efficacy and Side Effects of Intrathecal Morphine in Multimodal Analgesia for Unilateral Total Knee Arthroplasty[NCT03232957]		131 participants (Actual)	Interventional	2017-08-01	Completed
Effect of Paracetamol and Ibuprofen When Intravenously Given Combination or Alone in Reducing Morphine Requirements After Total Knee Arthroplasty[NCT04414995]	Phase 2/Phase 3	36 participants (Actual)	Interventional	2020-06-05	Completed
ED Treatment of Suicidal Patients With Ketamine Infusion[NCT03502551]	Phase 2	0 participants (Actual)	Interventional	2019-04-01	Withdrawn (stopped due to Trial never received funding.)
A Double Blind, Placebo Controlled, Fixed-Flexible Dose Clinical Trial of Guanfacine Extended Release for the Reduction of Aggression and Self-injurious Behavior Associated With Prader-Willi Syndrome[NCT05657860]	Phase 4	33 participants (Anticipated)	Interventional	2020-12-17	Recruiting
Low Dose Ketamine Infusion for Analgesia in the Emergency Department (ED) to Reduce Side Effects: A Double Blind, Double Dummy Randomized Controlled Trial[NCT05518877]	Phase 4	48 participants (Anticipated)	Interventional	2022-12-07	Recruiting
The Check Trial: A Comparison of Headache Treatment in the ED: Compazine Versus Ketamine. A Multi-Center, Randomized Double-Blind, Clinical Control Trial.[NCT02657031]	Phase 4	54 participants (Actual)	Interventional	2016-03-17	Completed
An Open-Label Clinical Trial of Simultaneous Administration of Oral Aspirin and Ketamine as Adjunct to Oral Antidepressant Therapy in Treatment-Resistant Depression[NCT05615948]	Phase 4	20 participants (Anticipated)	Interventional	2022-12-06	Recruiting
Cardiovascular and Neuropsychiatric Side Effects in Ketamine Analgesic Infusions in Acute Pain[NCT03979105]		300 participants (Actual)	Observational	2017-07-01	Completed
PCA Ketamine-Morphine Versus PCA Morphine as Post-Operative Analgesia in Colorectal Surgery[NCT06021717]	Phase 4	60 participants (Actual)	Interventional	2018-04-05	Completed
[information is prepared from clinicaltrials.gov, extracted Sep-2024]

Reduction of pain scores on numeric rating pain scale (NRS) at 60 minutes mark form the baseline. The NRS is an 11 item Likert Scale ranging from 0 (no pain) to 10 (very severe pain) with 5 indicating moderate pain. (NCT04860804)
Timeframe: 60 minutes

Average Daily Opioid Use as Measured by the Morphine Milligram Equivalents (MME) Per Day

Intervention	units on a scale (Mean)
AOK Group	2.18
OK Group	4.01

(NCT04129086)
Timeframe: In-hospital days (up to 6 weeks post hospital admission)

Duration of Ketamine Drip

Intervention	MME per day (Mean)
Ketamine Plus Usual Care	32
Usual Care	39

Length of time Ketamine drip was infused (NCT04129086)
Timeframe: Hospital discharge (up to 6 weeks post hospital admission)

Health Status as Assessed by the Euro-QOL EQ-5D-3L Questionnaire (Current Health)

Intervention	hours (Median)
Ketamine Plus Usual Care	60
Usual Care	76

"For this item of the Euro-QOL EQ-5D-3L questionnaire, participants are asked the question How would you rate your health today?, and they respond with a score from 0 - 100, with a higher score indicating a better outcome." (NCT04129086)
Timeframe: 6 months post admission

Health Status as Assessed by the Euro-QOL EQ-5D-3L Questionnaire (Current Health)

Intervention	score on a scale (Median)
Ketamine Plus Usual Care	75
Usual Care	80

Health Status as Assessed by the Euro-QOL EQ-5D-3L Questionnaire (Previous Experience)

Intervention	score on a scale (Median)
Ketamine Plus Usual Care	70
Usual Care	75

"For this item of the Euro-QOL EQ-5D-3L questionnaire, participants are asked the question Have you ever experience this kind of event?, and data are reported as the number of participants who responded yes." (NCT04129086)
Timeframe: 6 months post admission

Health Status as Assessed by the Euro-QOL EQ-5D-3L Questionnaire (Previous Experience)

Intervention	Participants (Count of Participants)
Ketamine Plus Usual Care	69
Usual Care	78

Hospital Free Days

Intervention	Participants (Count of Participants)
Ketamine Plus Usual Care	82
Usual Care	77

Number of days patients were not in the hospital during the first 30 days after admission (NCT04129086)
Timeframe: 30 days post admission

ICU Free Days

Intervention	days (Median)
Ketamine Plus Usual Care	20
Usual Care	21

Number of inpatient hospital days patients did not require ICU level of care (NCT04129086)
Timeframe: Hospital discharge (up to 6 weeks post hospital admission)

Number of Patients Requesting to Discontinue Ketamine

Intervention	days (Median)
Ketamine Plus Usual Care	29
Usual Care	28

Number of patients requesting to stop Ketamine for any complaint (NCT04129086)
Timeframe: Hospital discharge (up to 6 weeks post hospital admission)

Number of Patients That Required Unplanned Intubation During In-hospital Stay

Intervention	Participants (Count of Participants)
Ketamine Plus Usual Care	9
Usual Care	0

incidence of need for unplanned intubation during in-hospital stay (NCT04129086)
Timeframe: Hospital discharge (up to 6 weeks post hospital admission)

Number of Patients That Showed Signs of Delirium During In-hospital Stay

Intervention	Participants (Count of Participants)
Ketamine Plus Usual Care	2
Usual Care	3

Incidence of delirium during in-hospital stay (NCT04129086)
Timeframe: Hospital discharge (up to 6 weeks post hospital admission)

Number of Patients Who Continue to Use Opioids at 6 Months Post Admission

Intervention	Participants (Count of Participants)
Ketamine Plus Usual Care	16
Usual Care	9

Number of patients who continue to use opioids (NCT04129086)
Timeframe: 6 months post admission

Number of Patients Who Reported Continued Pain Continued Post-traumatic Pain at 6 Months Post Admission

Intervention	Participants (Count of Participants)
Ketamine Plus Usual Care	11
Usual Care	11

Number of patients who reported continued pain at 6 months following trauma injury (NCT04129086)
Timeframe: 6 months post admission

Number of Patients Who Required Unplanned Admission to Intensive Care Unit During In-hospital Stay

Intervention	Participants (Count of Participants)
Ketamine Plus Usual Care	78
Usual Care	71

Incidence of need for unplanned admission to an ICU (NCT04129086)
Timeframe: Hospital discharge (up to 6 weeks post hospital admission)

Pain as Assessed by Average Score on the Defense and Veterans Pain Rating Scale (DVPRS)

Intervention	Participants (Count of Participants)
Ketamine Plus Usual Care	7
Usual Care	7

DVPRS scores were collected daily. For each participant, an average of the daily scores on the Defense and Veterans Pain Rating Scale was calculated. DVPRS scores range from 0 (no pain) to 10 (as bad as it could be, nothing else matters), with a higher score indicating a worse outcome. (NCT04129086)
Timeframe: From time of admission to time of discharge from hospital (about 1 to 6 weeks after admission)

Ventilator Free Days

Intervention	score on a scale (Median)
Ketamine Plus Usual Care	2.9
Usual Care	2.5

Number of inpatient hospital days patients did not require mechanical ventilation (NCT04129086)
Timeframe: Hospital discharge (up to 6 weeks post hospital admission)

Health Status as Assessed by the Euro-QOL EQ-5D-3L Questionnaire (Anxiety/Depression)

Intervention	days (Median)
Ketamine Plus Usual Care	30
Usual Care	30

For this item of the Euro-QOL EQ-5D-3L questionnaire, participants are asked to indicate their level of anxiety/depression by choosing a predefined category, and the data for this outcome are reported categorically as the number of participants who chose each category. (NCT04129086)
Timeframe: 6 months post admission

Health Status as Assessed by the Euro-QOL EQ-5D-3L Questionnaire (Anxiety/Depression)

Intervention	Participants (Count of Participants)
	I am not anxious or depressed	I am slightly anxious or depressed	I am moderately anxious or depressed	I am severely anxious or depressed	I am extremely anxious or depressed
Ketamine Plus Usual Care	50	15	11	4	18
Usual Care	53	19	13	2	15

Health Status as Assessed by the Euro-QOL EQ-5D-3L Questionnaire (Mobility)

Intervention	Participants (Count of Participants)
	I am not anxious or depressed	I am slightly anxious or depressed	I am moderately anxious or depressed	I am severely anxious or depressed	I am extremely anxious or depressed
Ketamine Plus Usual Care	70	24	11	6	13
Usual Care	74	20	15	7	13

For this item of the Euro-QOL EQ-5D-3L questionnaire, participants are asked to indicate their level of mobility by choosing a predefined category, and the data for this outcome are reported categorically as the number of participants who chose each category. (NCT04129086)
Timeframe: 6 months post admission

Health Status as Assessed by the Euro-QOL EQ-5D-3L Questionnaire (Mobility)

Intervention	Participants (Count of Participants)
	I have no problems walking	I have slight problems walking	I have moderate problems walking	I have severe problems walking	I am unable to walk
Ketamine Plus Usual Care	50	15	12	9	14
Usual Care	47	21	17	8	9

Health Status as Assessed by the Euro-QOL EQ-5D-3L Questionnaire (Pain/Discomfort)

Intervention	Participants (Count of Participants)
	I have no problems walking	I have slight problems walking	I have moderate problems walking	I have severe problems walking	I am unable to walk
Ketamine Plus Usual Care	39	22	15	13	35
Usual Care	31	20	13	17	48

For this item of the Euro-QOL EQ-5D-3L questionnaire, participants are asked to indicate their level of pain/discomfort by choosing a predefined category, and the data for this outcome are reported categorically as the number of participants who chose each category. (NCT04129086)
Timeframe: 6 months post admission

Health Status as Assessed by the Euro-QOL EQ-5D-3L Questionnaire (Pain/Discomfort)

Intervention	Participants (Count of Participants)
	I have no pain or discomfort	I have slight pain or discomfort	I have moderate pain or discomfort	I have severe pain or discomfort	I have extreme pain or discomfort
Ketamine Plus Usual Care	31	17	21	10	21
Usual Care	25	21	24	18	14

Health Status as Assessed by the Euro-QOL EQ-5D-3L Questionnaire (Self-Care)

Intervention	Participants (Count of Participants)
	I have no pain or discomfort	I have slight pain or discomfort	I have moderate pain or discomfort	I have severe pain or discomfort	I have extreme pain or discomfort
Ketamine Plus Usual Care	25	34	30	21	14
Usual Care	16	32	39	18	24

Intervention	Participants (Count of Participants)
	I have no problems washing or dressing myself	I have slight problems washing or dressing myself	I have moderate problems washing or dressing myself	I have severe problems washing or dressing myself	I am unable to wash or dress myself
Ketamine Plus Usual Care	29	12	16	9	34
Usual Care	38	10	14	11	28

For this item of the Euro-QOL EQ-5D-3L questionnaire, participants are asked to indicate their level of self-care by choosing a predefined category, and the data for this outcome are reported categorically as the number of participants who chose each category. (NCT04129086)
Timeframe: Hospital discharge (about 1 to 6 weeks after admission)

Health Status as Assessed by the Euro-QOL EQ-5D-3L Questionnaire (Usual Activities)

Intervention	Participants (Count of Participants)
	I have no problems washing or dressing myself	I have slight problems washing or dressing myself	I have moderate problems washing or dressing myself	I have severe problems washing or dressing myself	I am unable to wash or dress myself
Ketamine Plus Usual Care	42	24	13	5	40
Usual Care	37	19	15	7	51

For this item of the Euro-QOL EQ-5D-3L questionnaire, participants are asked to indicate their ability to carry out usual activities by choosing a predefined category, and the data for this outcome are reported categorically as the number of participants who chose each category. (NCT04129086)
Timeframe: 6 months post admission

Health Status as Assessed by the Euro-QOL EQ-5D-3L Questionnaire (Usual Activities)

Intervention	Participants (Count of Participants)
	I have no problems doing my usual activities	I have slight problems doing my usual activities	I have moderate problems doing my usual activities	I have severe problems doing my usual activities	I am unable to do my usual activities
Ketamine Plus Usual Care	29	12	16	9	34
Usual Care	38	10	14	11	28

Number of Patients Discharged From the Hospital With an Opioid Prescription

Intervention	Participants (Count of Participants)
	I have no problems doing my usual activities	I have slight problems doing my usual activities	I have moderate problems doing my usual activities	I have severe problems doing my usual activities	I am unable to do my usual activities
Ketamine Plus Usual Care	17	8	5	2	92
Usual Care	7	10	9	4	99

Number of patients discharged from the hospital with an opioid prescription (NCT04129086)
Timeframe: Hospital discharge (up to 6 weeks post hospital admission)

Post Traumatic Stress Disorder (PTSD) as Assessed by the PC-PTSD-5 Questionnaire

Intervention	Participants (Count of Participants)
	Any Opioid at discharge	Tramadol	Hydrocodone	Oxycodone	Codeine	Methadone	Fentanyl patch	Hydromorphone	Morphine
Ketamine Plus Usual Care	82	72	3	10	1	0	0	0	1
Usual Care	97	81	2	15	3	0	0	0	0

"The PC-PTSD-5 questionnaire asks the below 5 questions, and data are reported categorically as the number of participants who responded yes to each of the 5 questions. An answer of yes is indicative of a PTSD symptom, which is a worse outcome.~In the past month, have you had nightmares about the events or thought about the events when you did not want to?~In the past month, have you tried hard not to think about the events or went out of your way to avoid situations that reminded you of the events?~In the past month, have you been constantly on guard, watchful, or easily startled?~In the past month, have you felt numb or detached from people, activities, or your surroundings?~In the past month, have you felt guilty or unable to stop blaming yourself or others for the events or any problems the events may have caused?" (NCT04129086)
Timeframe: 6 months post admission

Post Traumatic Stress Disorder (PTSD) as Assessed by the PC-PTSD-5 Questionnaire

Intervention	Participants (Count of Participants)
	1. had nightmares about the events or thought about the events when you did not want to	2. tried hard not to think about the events or went out of your way to avoid situations	3. been constantly on guard, watchful, or easily startled	4. felt numb or detached from people, activities, or your surrounding	5. felt guilty or unable to stop blaming yourself or others
Ketamine Plus Usual Care	24	41	42	37	24
Usual Care	19	44	47	36	23

Risk of Future Opioid Abuse as Assessed by the Opioid Risk Tool (ORT)

Intervention	Participants (Count of Participants)
	1. had nightmares about the events or thought about the events when you did not want to	2. tried hard not to think about the events or went out of your way to avoid situations	3. been constantly on guard, watchful, or easily startled	4. felt numb or detached from people, activities, or your surrounding	5. felt guilty or unable to stop blaming yourself or others
Ketamine Plus Usual Care	30	35	36	24	19
Usual Care	18	49	43	31	25

Total ORT score ranges from 0 to 26. A score of 3 or lower indicates low risk for future opioid abuse, a score of 4 to 7 indicates moderate risk for opioid abuse, and a score of 8 or higher indicates a high risk for opioid abuse. (NCT04129086)
Timeframe: Hospital discharge (about 1 to 6 weeks after admission)

Use of Other Pain Control Adjuncts Including Regional Anesthesia and Lidocaine Patch

Intervention	Participants (Count of Participants)
	Low risk of future opioid abuse (score of 0-3)	Moderate risk of future opioid abuse (score of 4-7)	High risk of future opioid abuse (score of 8 or higher)
Ketamine Plus Usual Care	92	13	19
Usual Care	94	25	10

Incidence of use of additional pain control adjuncts such as regional anesthesia and lidocaine patch during hospitalization (NCT04129086)
Timeframe: Hospital discharge (up to 6 weeks post hospital admission)

Adverse Events

Intervention	Participants (Count of Participants)
	Regional anesthesia	Lidocaine drip
Ketamine Plus Usual Care	16	0
Usual Care	20	0

"Frequency of adverse events secondary to ketamine including fatigue, dizziness, nausea, headache, feeling of unreality, changes in hearing or vision, mood changes, generalized discomfort, and hallucinations, changes in vital signs.~Adverse events were reported at baseline and then at 15 min/30 min/60 min/90 min and 120 minutes post-infusion." (NCT03896230)
Timeframe: Within 2 hours post infusion completion

Pain Score

Intervention	participants (Number)
	at 15 min post infusion	at 30 min post infusion	at 60 min post infusion	at 90 min post infusion	at 120 min post infusion
Arm 1: 0.1 mg/kg Ketamine	2	1	1	1	1
Arm 1: 0.2 mg/kg Ketamine	3	2	2	2	0
Arm 1: 0.3 mg/kg Ketamine	2	1	0	0	0

"Pain score using Numerical Rating Scale (NRS) post ketamine infusion. The Numerical Rating Scale (NRS) ranges from 0-to-10 with 0 being no pain and lower numbers representing less pain, so in this case lower numbers will represent better outcomes.~Pain scores were reported at baseline and then at 15 min/30 min/60 min/90 min and 120 minutes post-infusion." (NCT03896230)
Timeframe: Within 2 hours post infusion completion

Pain Score

Intervention	score on a scale (Mean)
	Baseline pain score	Pain score at 15 min	Pain score at 30 min	Pain score at 60 min	Pain score at 90 min
Arm 1: 0.3 mg/kg Ketamine	7.5	2	6	5	2
Arm 1: 0.2 mg/kg Ketamine	8.5	6	5.75	7	7

Breakthrough Daily Opioid Requirement

Intervention	score on a scale (Mean)
	Baseline pain score	Pain score at 15 min	Pain score at 30 min	Pain score at 60 min	Pain score at 90 min	Pain score at 120 min
Arm 1: 0.1 mg/kg Ketamine	9.4	5.25	5.25	5.25	4.5	4

Breakthrough daily opioid requirement in milligrams of morphine equivalents/day (NCT02062879)
Timeframe: Participants will be followed for their entire hospital stay, an expected average of 1 week

Median Pain Score

Intervention	mg morphine equivalents/day (Median)
Ketamine	10
Hydromorphone	10

Median daily pain score measures on a visual analogue scale for pain, with a range of 0 to 10. Higher scored indicate worse pain. (NCT02062879)
Timeframe: Participants will be followed for their entire hospital stay, an expected average of 1 week

Total Daily Opioid Requirement

Intervention	scores on a scale (Median)
Ketamine	6.3
Hydromorphone	5.3

Daily breakthrough opioid requirement plus non-breakthrough opioid use in milligrams of morphine equivalents (NCT02062879)
Timeframe: Participants will be followed for their entire hospital stay, an expected average of 1 week.

Incidence of Side Effects, Including Outlying Vital Signs

Intervention	mg morphine equivalents/day (Median)
Ketamine	10
Hydromorphone	42.5

The patient will be assessed for vital signs (blood pressure, heart rate, respiratory rate, oxygen saturation), Ramsay Sedation Scale (RSS) score at 5,10,20 minutes following medication administration and then every 20 minutes until a total of 120 minutes from the first dose of study medication. outlying vital signs recorded.( systolic Blood pressure less than 90mmHg or greater than 150mmHg, Heart rate less than 50bpm or greater than 150bpm, oxygen saturation below 90%, respiratory rate below 9breaths/minute or greater than 40breaths/minute and RSS of 1 or greater than 3) The RSS was used to asses the level of agitation or sedation caused by the intervention .the scale ranges from 1(anxious/agitated) to 6( no response to stimulus-deep sedation) with 2 being the optimal (cooperative, oriented and tranquil).A checklist for side effects like airway problems, allergic reactions, salivation, dysphoria,nystagmus, respiratory/cardiac arrest, awakening hallucinations, nausea/vomiting was used (NCT02434939)
Timeframe: 5, 10, 20, 40, 60, 80, 100, 120 minutes post drug administration

Incidence of Treatment Failure by Treatment Group.

Intervention	participants (Number)
Low Dose Ketamine	45
Morphine	4

Requiring more than two doses of the study medication provided for adequate pain control (NCT02434939)
Timeframe: 120 minutes

Maximal Change in NRS Pain Scores as a Percentage of Baseline NRS Pain Score.

Intervention	participants (Number)
Low Dose Ketamine	34
Morphine	48

Our primary outcome measurement was the maximum change on the verbal NRS pain scale compared with their initial score (baseline). The NRS was used to measure a patient's subjective level of pain on a scale from 0 (representing no pain at all) to 10 (the worst pain imaginable) using whole numbers. The NRS score was documented just prior to the administration of the study drug (time zero). After infusion of the study drug was complete, NRS scores were documented at 5, 10, 20, and then every 20 minutes thereafter up to 120 minutes. We stopped recording NRS scores prior to 120 minutes if the patient requested a third dose of the study drug, withdrew consent or developed a severe adverse effect. (NCT02434939)
Timeframe: 5, 10, 20,25,30, 40,45,50 60, 80, 100, 120 minutes post drug adminstration

Time to Maximal Analgesic Effect and Duration of Action of Ketamine

Intervention	percent change from baseline NRS score. (Mean)
	Overall	Excluding Treatment failures	Among Treatment failures	Those still at maximal effect at 120
Low Dose Ketamine	-66.4	-81.1	-33.8	-80
Morphine	-61.3	-79.8	-33.9	-81.7

"Following dosage with study medication, the amount of time taken to demonstrate the maximal change in the patient's NRS pain score.~Maximal change in NRS pain score is to be defined as the largest change from patient's baseline pain score. Duration of maximal change is how long the patient's pain score remained at this level." (NCT02434939)
Timeframe: 5, 10, 20, 40, 60, 80, 100, 120 minutes post drug administration

Reduction of Pain Score at 30 Minutes

Intervention	minutes (Mean)
	time to maximal effect	duration of maximal effect
Low Dose Ketamine	19.8	60
Morphine	34.1	58.5

The primary outcome will be the comparative reduction of NRS pain scores between the 2 groups at 30 minutes. The NRS Pain scale ranges from 0 to 10 (0 being no pain at all to 10 being very severe pain; 5 is moderate pain) (NCT02673372)
Timeframe: 30 minutes

Hallucination

Intervention	score on a scale (Mean)
Morphine Group	4.4
Ketamine Group	4.2

Hallucinations were documented and confirmed by the treating medical team. (NCT02432456)
Timeframe: Total Index Hospitalization up to 365 days

Length of Stay

Intervention	Participants (Count of Participants)
	Adult	Elderly
Ketamine Infusion	0	2
Placebo Infusion	1	2

Total hospital length of stay in days up to 365 days. (NCT02432456)
Timeframe: Total Index Hospitalization up to 365 days

Oral Morphine Equivalent (Narcotic Usage)

Intervention	days (Median)
	Adult	Elderly
Ketamine Infusion	5	5
Placebo Infusion	4.0	6

This is an analysis of the narcotic utilization during the study. Oral Morphine Equivalents is a means of standardizing narcotic utilization given a multitude of different medications are utilized. Medications are standardized to units (milligrams) or oral morphine for a standardized comparison. (NCT02432456)
Timeframe: 12-24 hours post infusion

Oral Morphine Equivalent (Narcotic Usage)

Intervention	oral morphine equivalents (Median)
	Adult	Elderly
Ketamine Infusion	45	21.3
Placebo Infusion	45.0	30

Oral Morphine Equivalent (Narcotic Usage) in Severely Injured

Regional Anesthesia Utilization

This is a measure of the Epidural Placement rates. Epidural placement was binary as in patient received or did not receive an epidural infusion catheter for supplemental pain management. (NCT02432456)
Timeframe: Total Index Hospitalization up to 365 days

Respiratory Failure

Respiratory failure within this trial was defined by the need for unanticipated intubation and/or transfer to ICU for respiratory support. (NCT02432456)
Timeframe: Total Index Hospitalization up to 365 days

Visual Analog Numeric Pain Score

Visual Analog Numeric Pain scores are reported as a single numeric score between 0 and 10. The more severe the pain the higher the number with 10 representing the most severe pain imaginable. (NCT02432456)
Timeframe: 12-24 hours post infusion

Visual Analog Numeric Pain Score

Change From Baseline of Pain as Described by Numeric Rating Scale (NRS) [Minimum:0, Maximum 10] at 15 Minutes

Change from Baseline of Pain as described by Numeric Rating Scale (NRS) [minimum:0, maximum 10] at 15 minutes. Lower values indicate worst outcomes while higher values indicate better outcomes. (NCT02306759)
Timeframe: 15 minutes after administration of study intervention

ED Length of Stay (Minutes)

ED Length of stay (minutes) throughout study period (NCT02306759)
Timeframe: throughout study completion

Number of Participants With Adverse Events

Incidence or number of participants with adverse events. (NCT02306759)
Timeframe: during the study period

Patient Satisfaction of Pain Control Based on a Likert Scale

Patient satisfaction of pain control based on a Likert Scale at the end of study completion, an average of 90 minutes. Scores reported out of scale of 10, 10 being most satisfied and 1 being least satisfied. (NCT02306759)
Timeframe: At the end of study period

Mean Consumption of Rescue Analgesia

(NCT02306759)
Timeframe: at designated intervals during study period (0, 15, 30, 45, 60, 75, 90, 105, 120 minutes)

Number of Participants With an Adverse Effects

We will monitor for adverse effects and record for changes in vital signs including nausea and vomiting, hypotension, respiratory depression, laryngospasm, and emotional and psychological effects (emergence reactions). (NCT02430818)
Timeframe: 60 minutes

Pain Treatment-VAS (Visual Analog Scale)

Study outcomes involve change in participants' pain as measured by a visual analog scale. The scale is a 10 inch line from 0 to 10 inches with 10 being the most pain and 0 being no pain. There are no units on the scale; it is just a straight line from no pain (0) to the worst pain (10). We assessed at o, 15, and 60 minutes but only scored the VAS at 60 minutes. (NCT02430818)
Timeframe: At 0 minutes and 60 minutes

Would the Participant Would Consider Using the Drug Given to Them for Pain Relief in the Future

Patients will be assessed to determine whether the participant would consider using the drug given to them for pain relief in the future. It was measured on a likert scale from 1-5 with 1 being did not like and would not use the drug again to 5 being like and would definitely receive the medication again. There are no units. The numbers below are the total number of patients that completed this answer. This was only asked on patients that received medication as if they did not receive medication the answer would not make sense. The median value is the likert value on a scale of 1-5 with the standard deviation. (NCT02430818)
Timeframe: 60 minutes

Change in Level of Pain Control as Reported on the NRS-11

"Patient-reported pain scores on numerical rating scale (NRS) -11 pain scale (where 0 indicates no pain at all, 10 indicates the most severe pain). Initial group were patients enrolled and randomized in to the study, assessments were taken at the time of enrollment/randomization in to the study (up to 20 min prior to T=0). T = 0 min assessments were conducted at the time of medication administration (study allowed for an up to 20-minute delay in receiving study drug in order to retrieve study drug from secure storage, nursing documentation and patient verification prior to administration)." (NCT02489630)
Timeframe: 20 min pre-medication administration, 0 min, 30 min, 60 min, 90 min, 120 min post medication administration

Change in Patient Satisfaction With Pain Control on a 1-4 Likert Scale

Patient-reported score regarding satisfaction with pain control, reported on a 4-point Likert scale (1-4, where 1 is the lowest satisfaction score possible and 4 is the highest satisfaction score possible). No data is reported for T = 0 min, as that assessment was conducted concurrently with initial medication dosing (since patients were at that point receiving their first pain control efforts, they could not yet assess their satisfaction with those efforts). (NCT02489630)
Timeframe: 0 min, 30 min, 60 min, 90 min, 120 min post medication administration

Difference in Opiate Dosage Between Study Arms in Morphine Equivalents

"Average difference in opiate dosage between study arms, calculated in morphine equivalents. Initial indicates at first dose of opioid administration, up to 20 mins prior to study drug administration, and from 0 min to 120 min after study drug administration." (NCT02489630)
Timeframe: 20 mins pre-medication administration, 0 min, 30 min, 60 min, 90 min, 120 min post medication administration

Effect of Low-dose Ketamine (LDK) on Opioid Usage in the ED

Opioid usage for at least one but up to three prior patient visits in the last one year for each patient enrolled in the study was summarized, expressed as morphine equivalents in mg/kg/h, to account for different types of opioids used per patient preference, and then this was compared to the intervention group that received LDK. Percent change in opioid usage (expressed as morphine equivalents in mg/kg/h) is reported). (NCT03296345)
Timeframe: Up to one year prior and after LDK administration on day 1 of the study in the ED

Effect of Low-dose Ketamine on Discharge Rates From the ED

"Percent discharge from the ED for intervention group and for at least one but up to three visits prior to receipt of ketamine in the last one year, were assessed. Participants were assigned a 0 if discharged or 1 if not discharged." (NCT03296345)
Timeframe: Up to one year prior to receipt of ketamine for the historical control arm/group and up to 18 months for the intervention arm/group

Effect of Low-dose Ketamine on Pain Scores on Presentation to the ED

Patient pain scores at presentation for the enrolled encounters and for at least one but up to three visits prior to receipt of ketamine in the last one year, were assessed. At least one but up to three prior visits were averaged and compared to the intervention visit. Pain was assessed using the faces pain scale which consists of a series of line diagrams of faces with expressions of increasing distress. The score ranges from 0 (no pain) to 10 (the worst pain). (NCT03296345)
Timeframe: Up to one year prior and on presentation to the ED after LDK administration

Effect of Low-dose Ketamine on Patient Pain Scores on Discharge From the ED/Admission to the Hospital

Patient pain scores at time of discharge from the ED/admission to the hospital for at least one but up to three visits prior to receipt of ketamine in the last one year, were assessed. At least one but up to three prior visits were averaged and compared to the intervention visit. Pain scores post receipt of ketamine are presented for the intervention group. Pain was assessed using the faces pain scale which consists of a series of line diagrams of faces with expressions of increasing distress. The score ranges from 0 (no pain) to 10 (the worst pain). (NCT03296345)
Timeframe: At time of discharge from the ED/admission to the hospital (up to one year prior and after LDK administration)

Effect of Low-dose Ketamine on Percent Difference of Length of Stay (LOS) in the ED

Length of stay (LOS) in minutes in the ED for at least one but up to three visits prior to receipt of ketamine in the last one year, were assessed. (NCT03296345)
Timeframe: Up to one year prior to and after LDK administration on day 1 of the study in the ED

Effect of Low-dose Ketamine on Time to 50% Pain Reduction

Time to 50% pain reduction (pain reported 50% less than baseline) in minutes for at least one but up to three visits prior to receipt of ketamine in the last one year, were assessed as historical controls. Pain was assessed using the faces pain scale which consists of a series of line diagrams of faces with expressions of increasing distress. The score ranges from 0 (no pain) to 10 (the worst pain). (NCT03296345)
Timeframe: Up to one year prior to and after LDK administration on day 1 of the study in the ED

Subjective Effect of Low Dose Ketamine on Pain Relief Assessed Via a Patient Survey

"After receipt of LDK, patients and/or their parents, based on age, filled out a survey based on a Likert scale regarding their agreement (Strongly Disagree to Strongly Agree) with the following statements: Achieved faster pain relief with LDK, Achieved more complete pain relief with LDK, and Desire to receive LDK in a future vaso-occlusive crisis. There is also an area where patients could provide general comments regarding their experience in receiving LDK.~Count of Participants who agree or strongly agree for each question are reported." (NCT03296345)
Timeframe: after LDK administration on day 1 of the study in the ED

ASES

American Shoulder and Elbow Surgeons (ASES) Shoulder Score for pain and function. Range 0-100. Low score = worse shoulder condition. Function, disability, and pain subscores (all ranges 0-50), and are summed for total ASES score. (NCT03540030)
Timeframe: 2 Weeks

Morphine Use

Morphine milli-equivalents In-hospital post-operative. Continuous scale of MME, no defined better/worse. Measured as number and dose of medications taken. For example, if the patient received an opioid, the drug and dose was recorded and converted to MME. A time frame of when to assess opioid use in-hospital post-operative was not used but was a continuous monitor for rescue opioid from in-hospital post-operative through discharge. (NCT03540030)
Timeframe: In-hospital Stay

Post Op Pain

Pain at patient discharge or 24-hours, whichever comes first - measured on a 0 (no pain) -10 (worst possible pain) numeric rating scale (NRS). A score of 0(no pain) is preferable to 10(worst possible pain) (NCT03540030)
Timeframe: 24 hours

Simple Shoulder Test

Simple Shoulder Test (SST) activity score. Range 0-12. 0 = worse activity score. (NCT03540030)
Timeframe: 2 Months

Simple Shoulder Test

Simple Shoulder Test (SST) activity score. Range 0-12. 0 = worse activity score. (NCT03540030)
Timeframe: 2 Weeks

Additional Post Op Pain

post-operative pain: measured on a 0 (no pain) -10 (worst) numeric rating scale (NRS) at 6hrs, 12hrs, 2 weeks, and 2 months. A score of 0(no pain) is preferable to 10(worst possible pain) (NCT03540030)
Timeframe: 6hrs, 12hrs, 2weeks, 2 months

Constipation

Falls

Nausea

Pain Satisfaction

Satisfaction with overall pain using Numeric Pain Rating (NRS) scale. yes, no. No being better than yes. (NCT03540030)
Timeframe: 2 Months

Pain Satisfaction

Satisfaction with overall pain using Numeric Pain Rating (NRS) scale. yes, no. No being better than yes. (NCT03540030)
Timeframe: 2 Weeks

quality of life using VR-12 subscores. Physical Health (PCS) subscore and Mental Health (MCS) subscore, not summed. Range reported in weighted units. Physical Health subscore: 1 point increase in PCS is associated with 6% lower total health care expenditures, 5% lower pharmacy expenditures, 9% lower rate of hospital inpatient visits, 4% lower rate of medical provider visits, 5% lower rate of hospital outpatient visits. Mental Health sub score a 1 point increase in MCS is associated with 7% lower total health care expenditures, 4% lower pharmacy expenditures, 15% lower rate of hospital inpatient visits, and 4% lower rate of medical provider visits. Both PCS/MCS are score 0-100 with 100 indicating the highest level of health. (NCT03540030)
Timeframe: 2 Months

Anxiety

Reduction in 100 mm Visual Analog Scale (VAS) Score. The maximum possible change in VAS score is 100 mm, representing the complete relief of maximum anxiety. A change of 0 mm corresponds to no change in anxiety level, and a negative value indicates worsening of the anxiety after the medication. (NCT02657031)
Timeframe: 0-60 minutes

Headache Following Intervention

Reduction in 100 mm Visual Analog Scale (VAS) Score. Positive values represent a reduction in headache severity. The maximum possible change in VAS score is 100 mm, representing the complete relief of a maximally severe headache. A change of 0 mm corresponds to no change in headache severity, and a negative value indicates worsening of the headache after the medication. (NCT02657031)
Timeframe: 0-60 minutes

Nausea

Reduction in 100 mm Visual Analog Scale (VAS) Score. The maximum possible change in VAS score is 100 mm, representing the complete relief of maximum nausea. A change of 0 mm corresponds to no change in nausea level, and a negative value indicates worsening of the nausea after the medication. (NCT02657031)
Timeframe: 0-60 minutes

Intervention	milligrams (Mean)
	T5	T15	T30	T45	T60	T75	T90	T105	T120
Placebo	0	0.14	0.28	0	0.22	0	0	0.42	0.42
Treatment	0	0.23	0.37	0.07	0	0	0.48	0.55	0

Intervention	Units on a scale (1-10) (Mean)
	Initial	T = 0 min	T = 30 min	T = 60 min	T = 90 min	T = 120 min
Ketamine	9.38	7.51	5.25	5.31	4.51	4.24
Placebo	9.44	8.10	2.27	6.18	6.21	5.68

Intervention	Milligrams of Morphine Equivalent (Mean)
	Initial Narcotic Dosage	Total Narcotic Dosage
Ketamine	5.41	9.95
Placebo	5.83	12.81

Intervention	Participants (Count of Participants)
	Achieved faster pain relief?	Achieved more complete pain relief?	Desire to receive LDK in the future?
Intervention	43	30	49

Intervention	score on a scale (Median)
	6 Hrs	12 hrs	2 weeks	2 months
Non-Opioid Intervention	0.0	0	0.82	0
Observational	2	4	1.3	0.7