Contributor: Lessen, Aaron MD

Educational Pearls:

• Ketamine can be given at 0.2-0.3 mg/kg as subdissociative doses for pain control in the ED
• • Ketamine coadministered with Haldol may reduce agitation
• A recent study in Iran compared subdissociative Ketamine given with 2.5 mg Haldol to 1 mg/kg Fentanyl for pain control in the ED
• • Ketamine with Haldol had better pain control than Fentanyl at 5, 10, 15 and 30 minutes
  • Ketamine with Haldol less frequently required rescue medication
  • Ketamine with Haldol did have increased agitation at only the 10 minute mark
  • Of note, there was not a Ketamine only group to compare
• Ketamine with Haldol is a viable alternative combination for pain control

References

Moradi MM, Moradi MM, Safaie A, Baratloo A, Payandemehr P. 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. Am J Emerg Med. 2022;54:165-171. doi:10.1016/j.ajem.2022.02.012

Sin B, Ternas T, Motov SM. The use of subdissociative-dose ketamine for acute pain in the emergency department. Acad Emerg Med. 2015;22(3):251-257. doi:10.1111/acem.12604

Summarized by Kirsten Hughes, MS4 | Edited by John Spartz, MD & Erik Verzemnieks, MD

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