Abstract Details

Title Efficacy and Safety of Ketamine Versus Morphine in Out-of-hospital Analgesia in Patients with Traumatic Pain: An Updated Systematic Review and Meta-analysis of Randomized Controlled Trials

Topic Pain

Presentation(s) P5 - Poster Session 5 (8:00 AM-9:00 AM)

Poster/Presentation
Number 7-005

Objective

To update the data about the safety and efficacy of ketamine compared to morphine in the pre-hospital management of traumatic pain.

Background Higher rates of adverse effects of morphine raises the need for safer and more effective alternatives. Many articles suggest ketamine as an alternative option to morphine.

Design/Methods We systematically searched PubMed/Medline, Scopus, Web of Science, and the Cochrane Library for RCTs comparing Ketamine versus Morphine for prehospital analgesia of traumatic pain. The primary outcome was the analgesic effect in terms of the mean difference of pain scores. Secondary outcomes included the vital signs changes and complications rates.

Results Out of 2027 reports, four studies were included in the final analysis, including 757 patients. The intervention group had a mean age of 41.9 (6) years, compared to 43.4 (7.3) years in the control group, with men accounting for 66% (n = 500). Pooled analysis revealed that ketamine wasn't more effective than morphine in terms of analgesic effect (mean difference [MD] = -0.90, [95% CI, -2.19 to 0.40, p=0.17]).Also, there was no significant difference between both arms in terms of change in the heart rate (MD = 0.40, 95% CI = [-2.08 to 2.88], p = 0.75), or respiratory rate (MD = 0.36, 95% CI = [-0.63 to 1.36], p = 0.72). On the other hand, there was a significant difference between the two arms in terms of change in systolic blood pressure favoring the control group (mean difference = 6.27, 95% CI = [2.97 to 9.57], p = 0.0002).Ketamine has higher incidence of adverse events compared to morphine (64.5% vs 35.5%).

Conclusions This meta-analysis shows that Ketamine is not superior to Morphine in terms of prehospital analgesia of traumatic pain and is associated with higher rate of adverse effects. We don’t recommend using ketamine as an alternative to morphine for prehospital analgesia.

Authors/Disclosures
Haneen Aljaiuossi, MD PRESENTER	Miss Aljaiuossi has nothing to disclose.
Mohammed B. Baker (Jordan University of Science and Technology)	Mr. Baker has nothing to disclose.
FADI Q. ALTAMIMI, Sr.	Dr. ALTAMIMI has nothing to disclose.
Layan Feras Khleifat, MD	Miss Feras Khleifat has nothing to disclose.
Toleen Haddad, MD	Miss Haddad has nothing to disclose.
Maha jaradat, MD, Medical student	Mrs. jaradat has nothing to disclose.
Mais H. khalil, Jr., Eng	Ms. khalil has nothing to disclose.

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