Category: Pharmacology & Therapeutics
Keywords: ketamine, pain, opioid (PubMed Search)
Emergency Departments are increasingly searching for alternatives to opioids for acute pain management.
An urban trauma center in California retrospectively evaluated their use of low-dose ketamine for acute pain over a two-year period. 
Application to Clinical Practice
There was no comparison group and there was no mention of what other pain medicines were given. Adverse events are often under-reported in retrospective studies. This study seems to demonstrate that low-dose ketamine administration for acute pain management in the ED is feasible with a low rate of adverse effects.
It's worth noting that a new review of 4 randomized controlled trials evaluating subdissociative-dose ketamine found no convincing evidence to support or refute its use in the ED. The 4 included trials had methodologic limitations. 
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