- Title
- Low-dose ketamine provides poor analgesia for pain in redback spider envenoming
- Creator
- Ryan, Nicole M.; James, Rosemary; Downes, Michael A.; Isbister, Geoffrey K.
- Relation
- NHMRC.1061041 http://purl.org/au-research/grants/nhmrc/1061041 & NHMRC.1110343 http://purl.org/au-research/grants/nhmrc/1110343
- Relation
- British Journal of Clinical Pharmacology Vol. 85, Issue 10, p. 2423-2427
- Publisher Link
- http://dx.doi.org/10.1111/bcp.14052
- Publisher
- Wiley
- Resource Type
- journal article
- Date
- 2019
- Description
- Redback spider envenoming causes severe pain lasting several days. A recent clinical trial found that antivenom is not effective. We investigated ketamine for pain in redback spider envenoming. Ten adult patients with severe pain from redback spider envenoming were administered 15 mg intravenous ketamine after standard analgesia, then up to 4 oral doses of ketamine 25- 50 mg. Three patients had a clinically significant improvement in pain compared to baseline after intravenous ketamine. Five patients had a minimal decrease in pain and 2 had no improvement. Eight patients received oral ketamine: 4 doses in 5 and 2 doses in 3. At 24 h, 3/6 patients assessed had clinically significant improvement in pain and 4/5 patients assessed at 48 h, had clinically significant improvement in pain. Six patients reported side effects, including dissociation (4) and hallucinations (2). Five patients required rescue opioids and 2 were readmitted to hospital. We found that ketamine provided no additional pain relief in redback spider envenoming, compared to standard analgesia, and resulted in unacceptable adverse effects.
- Subject
- envenoming; ketamine; pain; red-back spiderbite; toxin
- Identifier
- http://hdl.handle.net/1959.13/1417385
- Identifier
- uon:37203
- Identifier
- ISSN:0306-5251
- Rights
- This is the peer reviewed version of the following article: Ryan, N. M., James, R. & Downes, M. A. et al. (2019) Low-dose ketamine provides poor analgesia for pain in redback spider envenoming, British Journal of Clinical Pharmacology, 85(10) p2423-2427 which has been published in final form at: http://dx.doi.org/10.1111/bcp.14052. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.
- Language
- eng
- Full Text
- Reviewed
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