Journal article
Subhypnotic intravenous ketamine improves patient satisfaction with burn wound care: A Quality Improvement Project
Journal of burn care & research, Vol.45(3), pp.771-776
05/2024
DOI: 10.1093/jbcr/irad204
PMCID: PMC11073575
PMID: 38165669
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.
Details
- Title: Subtitle
- Subhypnotic intravenous ketamine improves patient satisfaction with burn wound care: A Quality Improvement Project
- Creators
- Albert Pedroza - University of Iowa, SurgeryZachary Fleishhacker - University of Iowa, SurgeryAlba Aguillon Paulsen - Division of Acute Care Surgery, Department of Surgery, University of Iowa, City, Iowa 52242, USAJia Ern Ong - University of Iowa, SurgeryNicolas Ronkar - University of Iowa, SurgeryIsaac Weigel - Division of Acute Care Surgery, Department of Surgery, University of Iowa, City, Iowa 52242, USATrinity Janecek - Division of Acute Care Surgery, Department of Surgery, University of Iowa, City, Iowa 52242, USAColette Galet - University of IowaLucy Wibbenmeyer - University of Iowa, Surgery
- Resource Type
- Journal article
- Publication Details
- Journal of burn care & research, Vol.45(3), pp.771-776
- DOI
- 10.1093/jbcr/irad204
- PMID
- 38165669
- PMCID
- PMC11073575
- NLM abbreviation
- J Burn Care Res
- ISSN
- 1559-047X
- eISSN
- 1559-0488
- Publisher
- Oxford University Press
- Grant note
- DOI: 10.13039/100006108, name: National Center for Advancing Translational Sciences, award: UM1TR004403; DOI: 10.13039/100000002, name: National Institutes of Health
- Language
- English
- Electronic publication date
- 01/02/2024
- Date published
- 05/2024
- Academic Unit
- Surgery; Injury Prevention Research Center; University of Iowa Health Care
- Record Identifier
- 9984538958402771
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