Low doses of ketamine, an anesthetic, can be a safe alternative to using the opioid fentanyl for pre-hospital pain management, according to a study conducted by a Spring-area ambulance district.

Explained

Harris County Emergency Services District No. 11, which provides ambulance services in a 177-square-mile area of northwest Houston, conducted the ketamine study from March 1, 2022-June 1, 2023, according to an April 7 news release from the district.

Ketamine is commonly used by paramedics, but usually it’s used for sedation, Jordan Anderson, study co-author and interim CEO, said in a May 6 interview.

“We wanted to be able to provide multiple avenues of pain management for patients,” Anderson said.


Paramedics administered low-dose ketamine via a nebulizer for pain management to 163 out of 1,480 patients while the rest received fentanyl, according to the study posted on ESD No. 11’s website. The study found that ketamine is a safe and effective way to treat patients with “traumatic pain.”

Put in perspective

Anderson said the benefits of treating patients’ pain with low-dose ketamine—which is administered through a nebulizer—over fentanyl include:
  • Less risk of lowering patient’s blood pressure
  • Less stress for patients who may experience anxiety when receiving an IV
  • Eliminated risk of relapse for patients with history of opioid addiction
“Say it's a patient that is a recovered opiate abuser,” Anderson said. “Well, if they got one dose of an opiate from a vehicle collision that might start the cycle of opiate addiction again.”

Looking ahead


Anderson said he does not see opportunities to expand services in the future due to the study, since ESD No. 11 paramedics already have the option to treat patients with ketamine at their discretion.

However, other pre-hospital providers can now look at ESD No. 11’s data and could implement similar protocols, Anderson said.

“One of the things that I think is cool about pre-hospital 911 is that we don't have competitors. ... So we're all very happy to share our data, read other people's data and make choices that benefit our community,” Anderson said.