{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T08:01:55Z","timestamp":1770710515627,"version":"3.49.0"},"reference-count":24,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,7,16]],"date-time":"2024-07-16T00:00:00Z","timestamp":1721088000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006197","name":"Fonden til L\u00e6gevidenskabens Fremme","doi-asserted-by":"publisher","award":["L\u20102022\u201000360"],"award-info":[{"award-number":["L\u20102022\u201000360"]}],"id":[{"id":"10.13039\/501100006197","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Pain is a common complaint among patients presenting to the emergency department (ED), yet pain treatment is frequently suboptimal. The aim of this study was to determine the effectiveness of low\u2010dose ketamine (LDK) as an adjunct to morphine versus morphine alone for treatment of acute pain among ED patients with and without current opioid use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Adult patients presenting with acute pain of \u22655 on a numeric rating scale (0\u201310) who were deemed by their treating ED physician to require intravenous opioids were randomized to receive either 0.1\u2009mg\/kg ketamine (treatment group) or isotonic saline (placebo) as an adjunct to morphine. Patients with and without current opioid use were randomized separately. Pain was measured at baseline (T0) and 10, 20, 30, 45, 60, and 120\u2009min after randomization. The primary outcome was pain reduction from T0 to T10. Secondary outcomes included pain intensity over 120\u2009min, need of rescue opioids, side effects, and patient and provider satisfaction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 116 patients were included from May 2022 to August 2023. Median (IQR) age was 51 (36.5\u201367)\u2009years; 58% were male and 36% had current opioid use. Pain reduction from T0 to T10 was greater in the LDK group (4 [IQR 3\u20136]) compared to the placebo group (1 [IQR 0\u20132]; <jats:italic>p<\/jats:italic>\u2009=\u20090.001). Pain intensity was lower in the LDK group at T10, T20, and T30, compared to the placebo group. There was a higher risk of nausea, vomiting, and dissociation in the LDK group during the first 10\u2009min.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>LDK may be effective as an adjunct analgesic to morphine for short\u2010term pain relief in treatment of acute pain in the ED for both patients with and without current opioid use.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.14983","type":"journal-article","created":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T05:18:10Z","timestamp":1721193490000},"page":"961-968","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Low\u2010dose ketamine as an adjunct to morphine: A randomized controlled trial among patients with and without current opioid use"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4569-7027","authenticated-orcid":false,"given":"Stine Fjendbo","family":"Galili","sequence":"first","affiliation":[{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"},{"name":"Research Center for Emergency Medicine Aarhus University Hospital  Aarhus Denmark"},{"name":"Department of Anaesthesiology and Intensive Care Aarhus University Hospital  Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bodil Hammer","family":"Bech","sequence":"additional","affiliation":[{"name":"Research Unit for Epidemiology, Department of Public Health Aarhus University  Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hans","family":"Kirkegaard","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"},{"name":"Research Center for Emergency Medicine Aarhus University Hospital  Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jette","family":"Ahrensberg","sequence":"additional","affiliation":[{"name":"Research Center for Emergency Medicine Aarhus University Hospital  Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lone","family":"Nikolajsen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"},{"name":"Department of Anaesthesiology and Intensive Care Aarhus University Hospital  Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,7,16]]},"reference":[{"issue":"4","key":"e_1_2_10_2_1","article-title":"Pain management in the emergency department: a review article on options and methods","volume":"2","author":"Abdolrazaghnejad A","year":"2018","journal-title":"Adv J Emerg Med"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11739-020-02411-2"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2017.07.013"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/aas.14351"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40263-019-00660-0"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.210878"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-4159.2011.07361.x"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2017.03.005"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2022-066444"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja16.00133"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.3945"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0304-3959(03)00176-3"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2018.09.004"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.12510"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.13172"},{"issue":"3","key":"e_1_2_10_17_1","article-title":"Intranasal ketamine administration for narcotic dose decrement in patients suffering from acute limb trauma in emergency department: a double\u2010blind randomized placebo\u2010controlled trial","volume":"2","author":"Mohammadshahi A","year":"2018","journal-title":"Adv J Emerg Med"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199612000-00017"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/aap.0000000000000806"},{"key":"e_1_2_10_20_1","unstructured":"Guidelines for the management of acute pain in emergency situations. 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