Study Shows Promise for Low-Dose Ketamine as Fentanyl Alternative for Prehospital Pain Control

A recent study examined the efficacy of low-dose ketamine administered intravenously as an alternative to IV fentanyl in the prehospital environment for severe pain. 

The retrospective review matched patients who received solely ketamine or fentanyl according to baseline levels of pain, on a one-to-one ratio and compared those pain levels to post-treatment pain scores. Results indicated that, compared to the group who received fentanyl IV, ketamine IV patients showed a significantly larger reduction in pain after treatment. Additionally, significantly more patients receiving the ketamine IV achieved at least a 50% reduction in pain compared to those receiving fentanyl IV (67% vs. 19%, p < 0.001).

Researchers also noted that "vital signs demonstrated a nonsignificant decrease in blood pressure, respiratory rate, heart rate, and GCS. No clinically significant adverse events were reported for patients receiving ketamine IV."

These findings add to the research indicating that ketamine could be used as an effective prehospital analgesic in place of fentanyl. What are your thoughts on replacing fentanyl with a low dose of ketamine for pain control in EMS?