Ketamine Patient Controlled Analgesia for Acute Pain in Trauma Patients: A Randomized, Active Comparator Controlled, Blinded, Pilot Trial

Abstract : It is unknown whether ketamine administered via patient-controlled analgesia provides adequate analgesia in trauma patients while reducing opioid consumption in the traumatically injured patient. The objective of this study was to compare differences in breakthrough opioid consumption. It was hypothesized that ketamine patient-controlled analgesia leads to decreased opioid use and similar pain scores compared to hydromorphone patient-controlled analgesia. This was an investigator-initiated, single-center, patient- and caregiver-blinded, randomized, pilot trial conducted from 2014-2016 in a surgical intensive care unit at a level 1 trauma center. Participants were native airway trauma patients with an injury severity score of greater than 9 who were receiving patient-controlled analgesia per the primary treating team. Four subjects in the ketamine group and one subject in the hydromorphone group withdrew from the study after initiating therapy.