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Observational Study
. 2023 Nov 4;23(1):130.
doi: 10.1186/s12873-023-00898-4.

Patient-reported side effects and satisfaction of pre-hospital analgesia with low-dose esketamine: a cross-sectional study

David Häske  1   2 , Fabian Eppler  3 , Niklas Heinemann  3 , Benjamin Schempf  3
Affiliations
Observational Study

Patient-reported side effects and satisfaction of pre-hospital analgesia with low-dose esketamine: a cross-sectional study

David Häske et al. BMC Emerg Med. .

Abstract

Background: Analgesia is a core intervention in emergency medicine. Pain is subjective, so patient-reported experience with pain and analgesia is essential for healthcare professionals. The aim of this study was to evaluate patient-reported side effects and satisfaction associated with pre-hospital analgesia with low-dose esketamine.

Methods: This is an observational cross-sectional study conducted as part of quality assurance measures of the German Red Cross Emergency Medical Service, Reutlingen, Germany. The survey was administered to all patients who received prehospital esketamine analgesia from paramedics. Addresses were obtained from medical records and mailed 10 days after the event. Patient feedback was anonymous and could not be linked to operational documentation.

Results: A total of 201 patients were contacted, and 119 responses were received via the online questionnaire and postal mail (response rate 59%). The mean age of the patients was 68±13 years, with 64.7% (n=77) being female. The main diagnosis reported was fractures of the extremities in 69.7%. Patients reported initial median pain intensity on a Numeric Rating Scale (NRS) of 10 [8-10]. Pain was unbearable for 96.3% of patients. After administration of analgesia, 95.3% were satisfied or very satisfied. Patients reported no side effects in 78.5%, minor side effects in 10.0%, significant but well tolerable side effects in 11.3%, borderline tolerable side effects in 0.2%, and no unbearable side effects. Borderline tolerable nausea was reported in 2% of patients along with dreams in 0.8%. No nightmares were reported. Further analysis showed that patients older than 80 years reported significantly more side effects (p < 0.001) and were thus less satisfied with the analgesia.

Conclusions: Both patient perception and analgesia with few side effects were important for both safety and satisfaction. In the present study, low-dose esketamine analgesia was associated with low side effects and high patient satisfaction.

Keywords: emergency; pain; paramedic; quality; safety.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Frequencies of side effects reported. The graph shows the side effects on the x-axis and their frequency in % on the y-axis
Fig. 2
Fig. 2
Patient-reported side effects in relation to age groups. If the severity (0=no side effects to 4= unbearable side effects) of the 12 side effects were summed, a total score between 0 and 48 would be possible. This shows that the age group <50 years reported no side effects, the age group 50-59 years was not represented, the age group 60-69 years had a median score of 0.5 [0-1.5], and the age group 70-70 years had a median score of 0 [0-2]. In contrast, the oldest age group, 80-89 years, had a median score of 5 [4-16]
Fig. 3
Fig. 3
Pain in function of the gender. This figure shows the pain score on the numeric rating scale (NRS) on the vertical axis and the frequencies of pain in % for men and women on the horizontal axis
See this image and copyright information in PMC

References

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