ArticleArchives of academic emergency medicine2020
The Efficacy of Ketamine Administration in Prehospital Pain Management of Trauma Patients; a Systematic Review and Meta-Analysis.
Article in Archives of academic emergency medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 3 syntheses or guidelines pooled it, 36 citations in OpenAlex.
- The 2023 WSES guidelines on the management of trauma in elderly and frail patients.World journal of emergency surgery : WJES · 2024Guideline
- So how special is special K? A systematic review and meta-analysis of ketamine for PTSD RCTs.European journal of psychotraumatology · 2024Pooled it
- Ketamine for the treatment of prehospital acute pain: a systematic review of benefit and harm.BMJ open · 2020Pooled it
- Paramedic analgesia comparing ketamine and morphine in trauma. A synopsis of the PACKMaN double-blind RCT.Health technology assessment (Winchester, England) · 2026Trial
- Trial
- Pain management of adults in the prehospital setting: a scoping review.BMC emergency medicine · 2026Article
- Prevalence and factors associated with acute pain among emergency trauma patients.World journal of emergency medicine · 2026Article
- Ketamine-From an Anesthetic to a Psychiatric Drug: Mechanisms of Action, Clinical Applications and Potential Risks.Molecules (Basel, Switzerland) · 2025Review
- Review
- Narrative Review: Low-Dose Ketamine for Pain Management.Journal of clinical medicine · 2023Review
- Review
- Incidence of Dissociation With Low-Dose Pre-hospital Ketamine in Geriatric Patients With Trauma-Related Pain.Cureus · 2022Article
- Efficacy and Safety of Intranasal Ketamine for Acute Pain Management in the Emergency Setting: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2021Article
- Ketamine Sub-Dissociative Dose Vs. Morphine Sulfate for Acute Pain Control in Patients with Isolated Limb Injuries in the Emergency Department: A Randomized, Double-blind, Clinical Trial.Bulletin of emergency and trauma · 2021Article
- Analgesia in adult trauma patients in physician-staffed Austrian helicopter rescue: a 12-year registry analysis.Scandinavian journal of trauma, resuscitation and emergency medicine · 2021Observational
- Ketamine infusion as a sedative-analgesic in severe ARDS (KISS).Journal of community hospital internal medicine perspectives · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAlthough previous articles and reviews suggest that ketamine might effectively manage pain in trauma patients, these articles have serious limitations. Accordingly, the current meta-analysis aims to investigate the efficacy of ketamine administration in prehospital pain management of trauma patients.
methodIn the present meta-analysis, controlled human studies were included. An extensive search was conducted in electronic databases including Medline (via PubMed), Embase, Central, Scopus, Web of Science, and ProQuest, gathering data to the end of 2018. The efficacy and side effects of ketamine administration in pre-hospital pain management were compared with those of opioid analgesics based on standard mean difference (SMD) and odds ratio (OR) calculations with 95% confidence interval (95% CI).
resultsData from seven articles were included in the present meta-analysis. Ketamine administration was not more effective than administrating morphine or fentanyl in prehospital pain management of trauma patients (SMD = -0.56, 95% CI: -1.38 to 0.26, p = 0.117). However, co-administration of ketamine+morphine was considerably more effective than ketamine alone, in alleviating pain in prehospital settings (SMD = -0.62, 95% CI: -1.12 to -0.12, p = 0.010). Finally, it was concluded that ketamine alone had less side effects than morphine alone (OR = 0.25, 95% CI: 0.11 to 0.56, p = 0.001). However, co-administration of ketamine+morphine increases the risk of side effects to 3.68 times compared to when morphine is prescribed solely (OR=3.68, 95% CI: 1.99 to 6.82, p<0.001).
conclusionFor the first time, findings of the current meta-analysis demonstrated that ketamine, being administered alone, is an effective and safe medication in prehospital pain management in trauma patients, and can be considered as an acceptable alternative to opioid analgesics.
Indexed as
Identifiers
32021982PMC6946038W3004210171What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.