Bad taste in the mouth and dizziness occur more frequently with intranasal ketamine than with intranasal fentanyl in children with suspected extremity fractures.
The lead author of the study is Stacy L. Reynolds, MD, director of the Pediatric Emergency Medicine Fellowship in the Department of Emergency Medicine at Carolinas Medical Center/Levine Children's Hospital.
‘There is no difference in the efficacy or pain relief between intranasal ketamine and intranasal fentanyl.’
Reynolds and colleagues, in their exploratory analysis, detected no difference in efficacy or pain relief between the two drugs. Additionally, no patient in either group experienced a serious adverse event, and none of the side effects required intervention.
Based on their findings, Reynolds, et al, recommends a larger, multicenter, non-inferiority study to more rigorously evaluate the safety, efficacy, and potential opioid-sparing benefits of intranasal ketamine analgesia for children with acute pain.
"There is less information about ketamine available than is needed to determine its role as first line pain therapy in children. This study starts to give us the information necessary to determine ketamine's place as a pain medication and its potential to replace opioids," said James R. Miner, MD, FACEP, chief of emergency medicine at the Hennepin County Medical Center and professor of emergency medicine at the University of Minnesota.