scholarly journals Hot Off the Press: A Systematic Review And Meta‐analysis of Ketamine as an Alternative to Opioids for Acute Pain in the Emergency Department

2018 ◽  
Vol 26 (8) ◽  
pp. 946-948 ◽  
Author(s):  
Corey Heitz ◽  
Justin Morgenstern ◽  
Christopher Bond ◽  
William K. Milne
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Acute Pain ◽  
Meta Analysis ◽  
The Press

scholarly journals A Systematic Review and Meta‐analysis of Ketamine as an Alternative to Opioids for Acute Pain in the Emergency Department

2018 ◽  
Vol 25 (10) ◽  
pp. 1086-1097 ◽  
Author(s):  
Nicholas Karlow ◽  
Charles H. Schlaepfer ◽  
Carolyn R. T. Stoll ◽  
Michelle Doering ◽  
Christopher R. Carpenter ◽  
...  
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Acute Pain ◽  
Meta Analysis

scholarly journals Efficacy and Safety of Intranasal Ketamine for Acute Pain Management in the Emergency Setting: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (17) ◽  
pp. 3978
Author(s):  
Yee Sin Seak ◽  
Junainah Nor ◽  
Tuan Hairulnizam Tuan Kamauzaman ◽  
Ariff Arithra ◽  
Md Asiful Islam
Keyword(s):  
Systematic Review ◽  
Pain Management ◽  
Acute Pain ◽  
Meta Analysis ◽  
Emergency Setting ◽  
Efficacy And Safety ◽  
Acute Pain Management ◽  
Significant Difference ◽  
Mean Differences ◽  
Randomised Controlled

Due to overcrowding, personnel shortages, or problematic intravenous (IV) cannulation, acute pain management is often sub-optimal in emergency departments (EDs). The objective of this systematic review and meta-analysis was to evaluate the efficacy and safety of intranasal (IN) ketamine for adult acute pain in the emergency setting. We searched and identified studies up to 21 May 2021 via PubMed, Scopus, Web of Science, Cochrane Database, and Google Scholar. The random-effects model with 95% confidence intervals (CIs) was used to estimate mean differences (MDs) and odds ratios (ORs). The I2 statistic and Cochran’s Q test were used to determine heterogeneity. The protocol was registered in PROSPERO (CRD42020213391). Seven randomised controlled trials were included with a total of 1760 patients. There was no significant difference in pain scores comparing IN ketamine with IV analgesics or placebo at 5 (MD 0.94, p = 0.26), 15 (MD 0.15, p = 0.74), 25 (MD 0.24, p = 0.62), 30 (MD −0.05, p = 0.87), and 60 (MD −0.42, p = 0.53) minutes. There was also no significant difference in the need for rescue analgesics between IN ketamine and IV analgesics (OR 1.66, 95% CI: 0.57−4.86, p = 0.35, I2 = 70%). Only mild adverse effects were observed in patients who received IN ketamine. Our results suggest that IN ketamine is non-inferior to IV analgesics and may have a role in acute pain management among adults in the ED.

Remifentanil vs. epidural analgesia for the management of acute pain associated with labour. Systematic review and meta-analysis☆

2014 ◽  
Vol 42 (4) ◽  
pp. 281-294
Author(s):  
Víctor Hugo González Cárdenas ◽  
Fredy Danilo Munar González ◽  
Wilson Javier Gómez Barajas ◽  
Angélica María Cardona ◽  
Byron Rafael Rosero ◽  
...  
Keyword(s):  
Systematic Review ◽  
Epidural Analgesia ◽  
Acute Pain ◽  
Meta Analysis

scholarly journals P097: The characteristics and effectiveness of interventions targeting chronic pain patients in the emergency department: A systematic review and meta-analysis

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S98-S99
Author(s):  
C. O'Rielly ◽  
L. Sutherland ◽  
C. Wong
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Chronic Pain ◽  
Meta Analysis ◽  
Grey Literature ◽  
Opioid Prescription ◽  
Care Plans ◽  
Individualized Care ◽  
High Utilizers ◽  
Ed Visits

Introduction: Patients with chronic non-cancer pain (CNCP) and opioid-use disorders make up a category of patients who present a challenge to emergency department (ED) providers and healthcare administrators. Their conditions predispose them to frequent ED utilization. This problem has been compounded by a worsening opioid epidemic that has rendered clinicians apprehensive about how they approach pain care. A systematic review has not yet been performed to inform the management of CNCP patients in the ED. As such, the purpose of this project was to identify and describe the effectiveness of interventions to reduce ED visits for high-utilizers with CNCP. Methods: Included participants were high-utilizers presenting with CNCP. All study designs were eligible for inclusion if they examined an intervention aimed at reducing ED utilization. The outcomes of interest were the number of ED visits as well as the amount and type of opioids prescribed in the ED and after discharge. We searched Medline, EMBASE, CINAHL, CENTRAL, SCOPUS, Web of Science, and the grey literature from inception to June 16, 2018. Two independent investigators assessed articles for inclusion following PRISMA guidelines. Risk of bias will be assessed using the Cochrane ROBINS-I and RoB 2 tools for non-randomized and randomized trials, respectively. Results: Following review, 14 of the 5,018 identified articles were included for analysis. These articles assessed a total of 1,670 patients from both urban and rural settings. Interventions included pain protocols or policies (n = 5), individualized care plans (n = 5), ED care coordination (n = 2), a chronic pain management pathway (n = 1), and a behavioural health intervention (n = 1). Intervention effects trended towards the reduction of both ED visits and opioid prescriptions. The meta-analysis is in progress. Conclusion: Preliminary results suggest that interventions aimed at high-utilizers with CNCP can reduce ED visits and ED opioid prescription. ED opioid-restriction policies that sought to disincentivize drug-related ED visits were most successful, especially when accompanied by an electronic medical record (EMR) alert to ensure consistent application of the policy by all clinicians and administrators involved in the care of these patients. This review was limited by inconsistencies in the definition of ‘high-utilizer’ and by the lack of high-powered randomized studies.

scholarly journals The Accuracy and Prognostic Value of Point‐of‐care Ultrasound for Nephrolithiasis in the Emergency Department: A Systematic Review and Meta‐analysis

2018 ◽  
Vol 25 (6) ◽  
pp. 684-698 ◽  
Author(s):  
Charles Wong ◽  
Braden Teitge ◽  
Marshall Ross ◽  
Paul Young ◽  
Helen Lee Robertson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Prognostic Value ◽  
Point Of Care ◽  
Meta Analysis ◽  
Point Of Care Ultrasound

Optimizing emergency department care transitions to outpatient settings: A systematic review and meta-analysis

2020 ◽  
Vol 38 (12) ◽  
pp. 2667-2680
Author(s):  
Fariba Aghajafari ◽  
Sayeeda Sayed ◽  
Nader Emami ◽  
Eddy Lang ◽  
Joanna Abraham
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Meta Analysis ◽  
Care Transitions ◽  
Emergency Department Care ◽  
Outpatient Settings
Sign in / Sign up

Export Citation Format

Share Document