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Subhypnotic intravenous ketamine improves patient satisfaction with burn wound care: A Quality Improvement Project
Journal article   Open access   Peer reviewed

Subhypnotic intravenous ketamine improves patient satisfaction with burn wound care: A Quality Improvement Project

Albert Pedroza, Zachary Fleishhacker, Alba Aguillon Paulsen, Jia Ern Ong, Nicolas Ronkar, Isaac Weigel, Trinity Janecek, Colette Galet and Lucy Wibbenmeyer
Journal of burn care & research, Vol.45(3), pp.771-776
05/2024
DOI: 10.1093/jbcr/irad204
PMCID: PMC11073575
PMID: 38165669
url
https://doi.org/10.1093/jbcr/irad204View
Published (Version of record) Open Access

Abstract

Despite advancements in pain management for burn injuries, analgesia often fails to meet our patients' needs. We hypothesized that low doses of intravenous ketamine as an adjunct to our current protocol would be safe, improving both nurse and patient satisfaction with analgesia during hydrotherapy. Burn patients admitted who underwent hydrotherapy from 6-1-2021 to 6-30-2023 were surveyed. Ketamine was administered with the standard opioid-midazolam regimen. Demographics, oral morphine equivalents (OME), midazolam, ketamine doses and time of administration, and adverse events were collected. Patient and nurse satisfaction scores were collected. The ketamine and no-ketamine groups were compared. P < 0.05 was considered significant. Eighty-five hydrotherapies were surveyed, 47 without ketamine and 38 with ketamine. Demographics, comorbidities, %TBSA, and hospital length of stay were not different. The median amount of ketamine given was 0.79 mg/kg [0.59-1.06]. Patients who received ketamine were more likely to receive midazolam (100% vs. 61.7%; p < 0.001) and both oral and IV opioids (94.7% vs. 68.1%; p = 0.002) prior to hydrotherapy and less likely to receive rescue opioids or midazolam during hydrotherapy. Two patients in the ketamine group had hypertension (defined as SBP > 180) that did not require treatment. Nurses tended to be more satisfied with patient pain control when ketamine was used (10 [8-10] vs. 9 [7-10], p = 0.072). Patient satisfaction was higher in the ketamine group (10 [8.8-10] vs. 9 [7-10], p = 0.006). Utilizing subhypnotic dose intravenous ketamine for hydrotherapy is safe and associated with increased patient satisfaction.
Pain patient satisfaction procedural pain wound care burn injury ketamine opioids

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