Oral ketamine eases opioid need during burn wound dressing changes

Oral administration of injectable ketamine results in a reduction in opioid requirements during burn wound dressing changes, reports a recent study. Use of ketamine also improves patient satisfaction.

“Preliminary data suggest this promising analgesia method is safe and effective for burn wound care,” the authors said.

This study sought to compare opioid usage and patient satisfaction scores in participants with and without the use of oral injectable ketamine for burn wound care; each patient also served as their own control. The authors then compared ketamine, opioid, and benzodiazepine dosages recorded during dressing changes to those without ketamine use occurring before and after ketamine-associated sessions in each patient.

Oral ketamine was administered to 14 patients at a median dose of 2.5 mg/kg (interquartile range [IQR], 2.2–2.7). Ketamine use led to a significant decrease in opioid requirements as compared with wound care sessions that did not use ketamine both before (50 [IQR, 30–75] vs 75 [IQR, 46–91] mg median intravenous [IV] morphine equivalents; p=0.0097) and after (50 [IQR, 30–75] vs 63 [IQR, 50–96] mg median IV morphine equivalents; p=0.0042) ketamine-related sessions.

There was one patient who experienced hallucinations, but no adverse events were reported. In addition, ketamine use resulted in improvement of patient satisfaction (p=0.0034).

“Both oral and IV ketamine are often used for analgesia and sedation… Oral ketamine wafers and tablets have been used as a safe alternative internationally but are unavailable in the United States,” the authors said.