Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jan 30:7:19.
doi: 10.4103/abr.abr_143_16. eCollection 2018.

Ketamine versus Ketamine / magnesium Sulfate for Procedural Sedation and Analgesia in the Emergency Department: A Randomized Clinical Trial

Reza Azizkhani  1 , Azadeh Bahadori  2 , Mohammadreza Shariati  1 , Keyhan Golshani  1 , Omid Ahmadi  1 , Babak Masoumi  1
Affiliations

Ketamine versus Ketamine / magnesium Sulfate for Procedural Sedation and Analgesia in the Emergency Department: A Randomized Clinical Trial

Reza Azizkhani et al. Adv Biomed Res. .

Abstract

Background: The present study was designed to evaluate the effectiveness of magnesium sulfate (MgSO4) in procedural sedation and analgesia (PSA) when combined with ketamine in patients with fractures in emergency departments and required short and painful emergency procedures.

Materials and methods: In this study, 100 patients with fractures and dislocations who were presented to the emergency departments and required PSA for short and painful emergency procedures were randomly allocated to groups of ketamine plus MgSO4 or ketamine alone. Train of four (TOF) stimulation pattern was assessed using nerve stimulator machine and compared between groups.

Results: The mean age of studied patients was 46.9 ± 9.3 years old. 48% were male and 52% were female. No significant differences were noted between groups in demographic variables. The status of TOF, 2 min after the injection of ketamine (1.5 mg/kg), in both groups was similar. After the injection of the second dose of ketamine (1 mg/kg) the status of TOF in four patients in ketamine plus MgSO4 (0.45 mg/kg) group changed, it was three quarters but in ketamine group, the status of TOF in all patients was four quarters. The difference between groups was not statistically significant (P = 0.12).

Conclusion: The findings revealed that for muscle relaxation during medical procedures in the emergency department, ketamine in combination with MgSO4 with this dose was not effective for muscle relaxation during procedures.

Keywords: Emergency room; ketamine; magnesium sulfate; procedural sedation and analgesia.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Flowchart of the study
Figure 2
Figure 2
Comparison of frequency of the train of four statuses between study groups by Chi-square test. Ketamine + magnesium sulfate group included fifty patients who received 0.45 mg/kg magnesium sulfate in combination to ketamine. Ketamine group included fifty patients who received normal saline in combination to ketamine. Before injection of magnesium sulfate and after that the difference in percent of train of four between study groups for train of four status was not statistically significant (after, P = 0.12)
See this image and copyright information in PMC

References

    1. Yatim FM. Intravenous ketamine is as effective as midazolam/fentanyl for procedural sedation and analgesia in the emergency department. Med J Malaysia. 2011;66:231. - PubMed
    1. Majidinejad S, Esmailian M, Emadi M. Comparison of intravenous ketamine with morphine in pain relief of long bones fractures: A Double Blind Randomized Clinical Trial. Emerg (Tehran) 2014;2:77–80. - PMC - PubMed
    1. Hosseini M, Karami Z, Janzadenh A, Jameie SB, Haji Mashhadi Z, Yousefifard M, et al. The effect of intrathecal administration of muscimol on modulation of neuropathic pain symptoms resulting from spinal cord injury; an experimental study. Emerg (Tehran) 2014;2:151–7. - PMC - PubMed
    1. Azizkhani R, Kanani S, Sharifi A, Golshani K, Masoumi B, Ahmadi O. Oral chloral hydrate compare with rectal thiopental in pediatric procedural sedation and analgesia; a randomized clinical trial. Emerg (Tehran) 2014;2:85–9. - PMC - PubMed
    1. Messenger DW, Sivilotti ML. Evidence-Based Emergency Medicine. Oxford, UK: Wiley-Blackwell; 2009. Procedural sedation and analgesia; pp. 551–60.

LinkOut - more resources