Morphine or Ketamine for Analgesia

Launched by COLUMBIA UNIVERSITY · Feb 17, 2025

Keywords

ClinConnect Summary

This clinical trial is studying whether a medication called sub-dissociative ketamine is just as effective as morphine for relieving severe pain in children who have abdominal pain or isolated fractures in their arms or legs. Morphine is commonly used for this purpose, but it can have serious side effects and raise concerns for both doctors and parents. The researchers hope that ketamine might be a safer option that could help avoid complications and improve overall well-being in the long run.

To be eligible for this trial, children must be between the ages of 2 and 17, have a pain score of 6 out of 10 or higher, and need intravenous (IV) morphine for pain relief as determined by their doctor. However, children who have certain health issues, allergies to the medications, or other specific conditions will not be able to participate. If your child is eligible, they will receive either ketamine or morphine in a controlled setting, and their pain relief will be closely monitored. This study aims to find a better way to manage pain in young patients while keeping their safety and health in mind.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. Abdominal pain or isolated long-bone extremity fracture (suspected or proven)
• • 2. Self-reported pain score of ≥ 6/10
• • 3. Requires IV morphine for analgesia as determined by the treating physician
• Exclusion Criteria:
• • 1. Weight \> 82.4 kg
• • 2. Known allergy/contraindication to morphine or ketamine
• • 3. Antecedent receipt of ketamine related to presenting complaint
• • 4. Inability to use self-report measures of pain or questionnaires
• • 5. Chronic disease associated with pain
• • 6. Chronic pain condition requiring use of opioids as outpatient
• • 7. Hemodynamic instability or critical illness per treating physician
• • 8. Altered mental state (e.g., GCS , 14 or clinical intoxication)
• • 9. Known history of schizophrenia, liver or kidney problems, or osteogenesis imperfecta
• • 10. Concern for open fracture, neurovascular compromise, or compartment syndrome
• • 11. Injuries in addition to the extremity injury (e.g., head, neck, abdomen)
• • 12. Known or reported pregnancy
• • 13. Does not speak English or Spanish
• • 14. Patient previously enrolled in this study
• • 15. Wards of state, foster children, or children in custody