Daniel J. Pallin, MD, MPH reviewing Farnia MR et al. Am J Emerg Med 2016 Nov 22.

A small trial finds the two options to have similar efficacy at 30 minutes.

Ketamine is coming into wider use as an analgesic. In a randomized, double-blind, controlled trial, investigators in Iran compared the efficacy of intranasal ketamine versus intravenous morphine in 40 emergency department patients with acute renal colic.

Patients received either 1 mg/kg intranasal ketamine plus intravenous placebo or 0.1 mg/kg intravenous morphine plus intranasal placebo. Pain was rated on a 10-point visual analog scale at baseline and at 5, 15, and 30 minutes after injection.

The initial average pain scores in the ketamine and morphine groups were 8.4 and 7.4, respectively. In analyses that accounted for differences in scores at earlier time points, mean scores at 30 minutes were 4.2 and 4.0, respectively.

CITATION(S):

Farnia MR et al. Comparison of intranasal ketamine versus intravenous morphine in reducing pain in patients with renal colic. Am J Emerg Med 2016 Nov 22; [e-pub]. 

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