Ketamine and Morphine Versus Morphine Alone for the Treatment of Acute Pain in the Emergency Department

Not Applicable

Terminated

Brief Summary: Our goal is to study whether giving people low dose ketamine along with morphine when they come to the Emergency Department will help their pain more than giving morphine by itself. There have been many studies showing that low dose ketamine is safe and effective for pain control. Ketamine is frequently used for pain control in ambulances and helicopters transporting injured patients to the hospital and has also been used for pain control in people who have just had surgery. The investigators would like to see if low dose ketamine would be safe and effective for patients with pain in the Emergency Department.

Patients are eligible for the study if they come to the Emergency Department and their treating physician decides to treat them with morphine (with certain exceptions such as pregnant patients and patients with eye injuries). They will be given information about participating in the study and if they agree, they will be given the study drug. The study drug will be either ketamine or salt water (saline). If patients continue to be in pain they will continue to receive doses of morphine just as they would if they were not in the study. If the treating physician feels that morphine alone is not enough, they will be free to choose another pain medication as they would normally.

Recruitment & Eligibility

Inclusion Criteria

Exclusion Criteria

Patients presenting with headache or head injury
Patient with eye injury or eye pain
Nontraumatic chest Pain
Pregnant patients or women of childbearing potential
Patients allergic to morphine or ketamine
Patients with known history of narcotic/alcohol abuse or presenting for narcotic medication refill
Patients with hypertension: diastolic blood pressure > 100 OR systolic blood pressure > 180
Patient whose pain is so severe that they are unable to give informed consent
Patients who have had bad experiences to prior hallucinations from any origin

Arm && Interventions

Group	Intervention	Description
Morphine and placebo	Morphine	Patient's will receive morphine during the usual course of their emergency department care and will receive a saline in a volume equivalent to the ketamine administered in the experimental arm of the stuy
Morphine and placebo	placebo	Patient's will receive morphine during the usual course of their emergency department care and will receive a saline in a volume equivalent to the ketamine administered in the experimental arm of the stuy
Morphine and Ketamine	Ketamine	Patient's will receive a 0.3mg/kg dose of ketamine in addition to morphine given in the usual course of emergency department care
Morphine and Ketamine	Morphine	Patient's will receive a 0.3mg/kg dose of ketamine in addition to morphine given in the usual course of emergency department care

Primary Outcome Measures

Name	Time	Method
Numeric Pain Score	Baseline (zero minutes), 30 minutes and 1 hour after receiving study drug	Pain 0-10 with 0 being no pain and 10 being the worst pain

Secondary Outcome Measures

Name	Time	Method
Total Amount of Morphine and Other Pain Medications Administered	Data collected from the duration of the patient's Emergency Department stay (expected average 5 hours)
Number of Participants With Adverse Events	Data collected from the duration of the patient's Emergency Department stay (expected average 5 hours)