{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T03:20:23Z","timestamp":1783394423525,"version":"3.54.6"},"reference-count":23,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,2,16]],"date-time":"2021-02-16T00:00:00Z","timestamp":1613433600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aimed to determine if 0.15\u00a0mg\/kg intravenous (IV) subdissociative ketamine is noninferior to 0.3\u00a0mg\/kg in emergency department (ED) patients with acute pain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This randomized, prospective, double\u2010blinded, noninferiority trial included patients\u2019 age 18 to 59\u00a0years presenting to the ED with acute moderate to severe pain. Subjects were randomized to IV subdissociative ketamine, 0.15\u00a0mg\/kg (\"low\" dose) or 0.30\u00a0mg\/kg (\"high\" dose), over 15 minutes. The primary endpoint was the 11\u2010point numeric rating scale (NRS) pain score between groups at 30 minutes. Secondary endpoints included NRS pain scores at 15 and 60 minutes; change in NRS at 15, 30, and 60 minutes; rescue analgesia; and adverse effects. The noninferiority limit, <jats:italic>\u03b4<\/jats:italic><jats:sub>0<\/jats:sub>, was set to 1.3.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010nine patients were included in each group. After the differences in the baseline NRS score were adjusted for, the mean NRS score at 30 minutes was 4.7 (95% confidence interval [CI]\u00a0= 3.8 to 5.5) in the low\u2010dose group and 5.0 (95% CI\u00a0= 4.2 to 5.8) in the high\u2010dose group (mean difference\u00a0= 0.4, 95% CI\u00a0= \u22120.8 to 1.5), indicating that the low\u2010dose subdissociative ketamine was noninferior to the high dose (lower limit of 95% CI\u00a0=\u00a0\u20130.8 to \u22651.3\u00a0= \u2013<jats:italic>\u03b4<\/jats:italic><jats:sub>0<\/jats:sub>). Adverse effects were similar at 30 minutes. At 15 minutes, the high\u2010dose group experienced greater change in NRS; however, more adverse effects occurred.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our data did not detect a large difference in analgesia or adverse effect profile between\u00a00.15\u00a0mg\/kg IV ketamine and\u00a00.30\u00a0mg\/kg in the short\u2010term treatment of acute pain in the ED.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.14200","type":"journal-article","created":{"date-parts":[[2020,12,24]],"date-time":"2020-12-24T00:10:18Z","timestamp":1608768618000},"page":"647-654","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["A randomized, noninferiority, controlled trial of two doses of intravenous subdissociative ketamine for analgesia in the emergency department"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7952-3477","authenticated-orcid":false,"given":"Shannon","family":"Lovett","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine Loyola University Chicago Stritch School of Medicine Maywood Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trent","family":"Reed","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Loyola University Chicago Stritch School of Medicine Maywood Illinois USA"},{"name":"Department of Medical Education Loyola University Chicago Stritch School of Medicine Maywood Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Riggs","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Loyola University Chicago Stritch School of Medicine Maywood Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Lew","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Loyola University Chicago Stritch School of Medicine Maywood Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Koch","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Vanderbilt University Medical Center Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramon A.","family":"Durazo\u2010Arvizu","sequence":"additional","affiliation":[{"name":"School of Health Sciences and Public Health Loyola University Chicago Maywood Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6542-518X","authenticated-orcid":false,"given":"Megan A.","family":"Rech","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Loyola University Chicago Stritch School of Medicine Maywood Illinois USA"},{"name":"Department of Pharmacy Loyola University Medical Center Maywood Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,2,16]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Centers for Disease Control and Prevention.FastStats \u2010 Emergency Department Visits. 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