{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T15:10:30Z","timestamp":1773933030567,"version":"3.50.1"},"reference-count":16,"publisher":"Danish Medical Association","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dan Med J"],"abstract":"<jats:p>INTRODUCTION. S-ketamine is increasingly used as an adjunct to opioids for prehospital traumatic pain, but data on patient experience and safety in civilian paramedic practice remain limited. We evaluated low-dose S-ketamine, alone or with fentanyl, in a Danish prehospital setting.\n\nMETHODS. This was a prospective observational study including adult prehospital patients with pain from significant trauma, suspected fractures of long bones, spine or pelvis, or joint dislocations. Paramedics administered intravenous S-ketamine, usually after fentanyl, and recorded pain using a numerical rating scale (NRS) and an electronic questionnaire on efficacy, side effects and patient experience. Data completeness was ensured by twice-weekly electronic record searches and follow-up.\n\nRESULTS. Among 348 patients, 320 (92.0%) reported effective pain relief, with a median NRS reduction of five points. In the combination group, the median fentanyl dose was 150 \u00b5g (IQR: 100-200 \u00b5g), and the median ketamine dose was 10 mg (IQR: 10-20 mg). In the monotherapy group, the median ketamine dose was 15 mg (IQR: 10-20 mg). Hallucinations occurred in 30.0% (23.9% positive, 6.0% negative) and diplopia in 9.2%. Blood pressure changes &gt; 20 mmHg occurred in 10.1% and tachycardia in 8.0%, with no serious adverse events. Overall, 93.2% stated they would accept S-ketamine again.\n\nCONCLUSIONS. In this prospective observational cohort, low-dose S-ketamine, administered alone or in combination with fentanyl, was associated with effective prehospital analgesia, infrequent and predominantly benign side effects and high patient satisfaction.\n\nFUNDING. None.\n\nTRIAL REGISTRATION. Not relevant.<\/jats:p>","DOI":"10.61409\/a08250694","type":"journal-article","created":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T08:53:09Z","timestamp":1771923189000},"page":"1-9","source":"Crossref","is-referenced-by-count":0,"title":["Low-dose S-ketamine for prehospital pain relief"],"prefix":"10.61409","author":[{"given":"Daniel","family":"Wittrock","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lars-Gustav Rahbek","family":"Nielsen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henning Morthorst","family":"Lassesen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Poul Fredslund","family":"Pedersen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonas","family":"Emdal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian Nyby","family":"Bergholdt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lars Bak","family":"Nielsen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jakob","family":"Oxlund","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S\u00f8ren","family":"Mikkelsen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"40208","published-online":{"date-parts":[[2026,2]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"Whitley GA, Wijegoonewardene N, Nelson D, et al. Patient, family member, and ambulance staff experiences of prehospital acute pain management in adults: a systematic review and meta-synthesis. J Am Coll Emerg Physicians Open. 2023;4(2):e12940. https:\/\/doi.org\/10.1002\/emp2.12940","DOI":"10.1002\/emp2.12940"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Albrecht E, Taffe P, Yersin B, et al. Undertreatment of acute pain (oligoanalgesia) and medical practice variation in prehospital analgesia of adult trauma patients: a 10-year retrospective study. Br J Anaesth. 2013;110(1):96-106. https:\/\/doi.org\/10.1093\/bja\/aes355","DOI":"10.1093\/bja\/aes355"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Friesgaard KD, Kirkegaard H, Rasmussen CH, et al. Prehospital intravenous fentanyl administered by ambulance personnel: a cluster-randomised comparison of two treatment protocols. 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