Intranasal ketamine as an analgesic agent for acute pain management in emergency department: A literature review

作     者：Abdolghader Pakniyat Morteza Qaribi Dorin Rahnama Hezaveh Ali Abdolrazaghnejad 

作者机构：Department of emergency MedicineFaculty of MedicineKurdistan University of medical sceincesSanandajIran Department of Emergency MedicineSchool of MedicineArak University of Medical SciencesArakIran School of MedicineMedical University of LublinLublinPoland Department of Emergency MedicineKhatam-Al-Anbia HospitalZahedan University of Medical SciencesZahedanIran 

出 版 物：《Journal of Acute Disease》 (急性病杂志（英文版）)

年 卷 期：2018年第7卷第6期

页      面：241-246页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Administration Intranasal Emergency department Ketamine Pain management Review literature 

摘      要：Ketamine is a well-known dissociative anesthetic agent, and has been used over 50 years. Intranasal pathway is a mucosal way for absorbing agents to directly affect in brain via olfactory sheets, bypassing first pass metabolism and the blood brain barrier. The current uses of intranasal ketamine as an analgesic agent for acute pain management in emergency department are discussed in this review article. Using ketamine , pain or analgesia , and intranasal as keywords, a search of google scholar, Pubmed, web of science, and Medline database from 1970 until 2017 was performed. Finally, from 1204 papers extracted via primary search, 1088 papers were omitted and finally 10 studies were considered for further assessment. There were four observational studies, one case series and report and 5 clinical trials. Ketamine was used for acute pain control due to musculoskeletal trauma, burns, and painful procedures. A total of 390 cases were included in these studies. The studies used ketamine with doses ranging 0.45-1.25 mg/kg via intranasal pathway. Intranasal ketamine provides relatively rapid, well tolerated, and clinically significant analgesia for emergency department patients. Considering the lack of adequate studies and undetermined intranasal dose, it is better to conduct further high quality investigation in both adults and pediatrics.