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Purpose: The WHO guidelines on cancer pain management recommend a sequential three-step analgesic ladder. However, conclusive data are lacking as to whether moderate pain should be treated with either step II weak opioids or low-dose step III strong opioids. Patients and methods: In a multicenter, day, open-label randomized controlled study, adults with moderate cancer pain were ased to receive either a weak opioid or low-dose morphine.

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When you have a mild headache or muscle ache, an over-the-counter pain reliever is usually enough to make you feel better.

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Objectives: Low-dose ketamine has been used perioperatively for pain control and may be a Low dose painkillers adjunct to intravenous IV opioids in the control of acute pain in the emergency department ED. The aim of this study was to determine the effectiveness of low-dose ketamine as an adjunct to morphine versus standard care with morphine alone for the treatment of acute moderate to severe pain among ED patients. Methods: A double-blind, randomized, placebo-controlled trial with three study groups was conducted at a large, urban academic ED over a month period.

The three study groups were: 1 morphine and normal saline placebo standard care group2 morphine and 0. The primary outcome measure of pain relief, or pain intensity reduction, was derived using the NRS and calculated as the summed pain-intensity SPID difference over 2 hours. The amount and timing of rescue opioid analgesia was evaluated as a secondary outcome.

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The occurrence of adverse events was also measured. Over the 2-hour poststudy medication administration period, the SPIDs were higher greater pain relief for the ketamine study groups than the control group standard care 4. When compared to standard care, group 2 sustained the reduction in pain intensity up to 2 hours, whereas group 1 was similar to standard care by 2 hours.

Among those receiving rescue analgesia, those in the standard care group received analgesia sooner than either low-dose ketamine group, on average. More participants in the low-dose ketamine groups reported dysphoria and dizziness. Conclusions: Low-dose ketamine is a viable analgesic adjunct to morphine for the treatment of moderate to severe acute pain.

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Save Cancel. Create a file for Low dose painkillers citation management software Create file Cancel. of items displayed: 5 10 15 20 50 Create RSS Cancel. RSS Link Copy. Full text links Cite Display options Display options. Abstract Objectives: Low-dose ketamine has been used perioperatively for pain control and may be a useful adjunct to intravenous IV opioids in the control of acute pain in the emergency department ED. Similar articles A comparison of ultrasound-guided three-in-one femoral nerve block versus parenteral opioids alone for analgesia in emergency department patients with hip fractures: a randomized controlled trial.

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Acad Emerg Med. Bowers KJ, et al. Epub Mar Intravenous subdissociative-dose ketamine versus morphine for acute geriatric pain in the Emergency Department: A randomized controlled trial. Motov S, et al.

Am J Emerg Med. Epub May The use of subdissociative-dose ketamine for acute pain in the emergency department. Sin B, et al.

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Epub Feb PMID: Review. J Emerg Med. Epub Sep See all similar articles. Cited by 23 articles Commonly used agent for acute pain management of sickle cell anemia in Saudi Emergency Department: A narrative review. Hejazi RA, et al. Saudi Pharm J. Grill J, et al. Spartan Med Res J. Jabourian A, et al.

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Mo H, et al. West J Emerg Med. Sex differences in prescription opioid use patterns assessed through a community engagement program in Florida. Serdarevic M, et al. Drug Alcohol Depend.

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