Comparison of two analgesia protocols for the treatment of pediatric orthopedic emergencies

Abstract

Results: 13 patients were allocated to ketamine and 12 to morphine, without differences in relation to age, weight, gender, type of injury, and pain scale before the intervention. There was no failure in any of the groups, no differences in time to start the intervention and overall procedure time. The average hospital stay time was similar (ketamine = 10.8+5.1h versus morphine = 12.3+4.4hs; p=0.447). The median pain (faces pain scale) scores after the procedure was 2 in both groups. Amnesia was noted in 92.3% (ketamine) and 83.3% (morphine) (p=0.904). Parents said they were very satisfied in relation to the analgesic intervention (84.6% in the ketamine group and 66.6% in the morphine group; p=0.296). The satisfaction of the orthopedist regarding the intervention was 92.3% in the ketamine group and 75% in the morphine group (p=0.222). Conclusion: by producing results similar to morphine, ketamine can be considered as an excellent option in pain management and helps in the reduction of dislocations and closed fractures in pediatric emergency rooms.

Protocolos nacionais e internacionais para manejo de dor em unidade de terapia intensiva adulta / National and international protocols for pain management in adult intensive therapy unit

“…Embora esses métodos nem sempre são aplicáveis em unidades de terapia intensiva devido à presença de tubo endotraqueal e ventilação mecânica. O uso de escalas para dor pode ser um item adicional no momento da alta do paciente (BARCELOS et al, 2015).…”

Efficacy and Safety of Morphine and Low Dose Ketamine for Pain Control of Patients with Long Bone Fractures: A Randomized, Double-Blind, Clinical Trial

“…At high doses drug causes hallucination, disturbed sleep, increased intracranial pressure, high blood pressure, tachycardia, and tonic-clonic seizure [7]. Several studies have shown that ketamine is effective agent in the treatment of pain [8] and morphine is the most commonly used analgesic in emergency centers [5,[9][10][11][12][13][14][15][16]. Intravenous ketamine is an available agent associated with minimal complications and side effects while the morphine is less available and associated with several side effects such as tolerance [10][11][12][13].…”