Comparison of Ketamine and Tramadol in Management of Acute Pain; a Systematic Review
Archives of Academic Emergency Medicine,
Vol. 8 No. 1 (2020),
7 January 2020
Introduction: Management of pain is an important part of care in the emergency department (ED). Tramadol and Ketamine have both been introduced as alternatives to opioids in the ED and post-operative setting. In this study, we conducted a systematic review of available literature to compare the analgesic efficacy, and side effect profile of these two medications in management of severe acute pain.
Methods: This is a systematic review based on the PRISMA protocol. In this study, peer-reviewed papers published by March 3, 2020, which compared analgesic effects of tramadol and ketamine in management of acute pain were included.
Result: The initial search of online databases identified 2826 non-duplicate records. Finally, three papers available in full text were analyzed for study quality. The results show that ketamine has consistently been shown to be superior to tramadol for pain control and causes fewer significant side effects.
Conclusion: Results of this review show that low-dose ketamine is more effective than tramadol in pain control, while causing fewer side effects.
- Ketamine; Tramadol; pain management; emergency treatment; acute pain
How to Cite
Todd KH, Ducharme J, Choiniere M, Crandall CS, Fosnocht DE, Homel P, et al. Pain in the emergency department: results of the pain and emergency medicine initiative (PEMI) multicenter study. The journal of pain. 2007;8(6):460-6.
Imani F, Safari S. “Pain relief is an essential human right”, we should be concerned about it. Anesthesiology and pain medicine. 2011;1(2):55.
Bijur PE, Mills AM, Chang AK, White D, Restivo A, Persaud S, et al. Comparative Effectiveness of Patient-Controlled Analgesia for Treating Acute Pain in the Emergency Department. Ann Emerg Med. 2017;70(6):809-18.e2.
Helander EM, Menard BL, Harmon CM, Homra BK, Allain AV, Bordelon GJ, et al. Multimodal Analgesia, Current Concepts, and Acute Pain Considerations. Curr Pain Headache Rep. 2017;21(1):3.
Motov S, Yasavolian M, Likourezos A, Pushkar I, Hossain R, Drapkin J, et al. Comparison of intravenous ketorolac at three single-dose regimens for treating acute pain in the emergency department: a randomized controlled trial. Annals of emergency medicine. 2017;70(2):177-84.
Faridaalaee G, Mohammadi N, Merghati SZ, Keyghobadi Khajeh F, Naghipour B, Pouraghaei M, et al. Intravenous Morphine vs Intravenous Ketofol for Treating Renal Colic; a Randomized Controlled Trial. Emerg (Tehran). 2016;4(4):202-6.
Subedi M, Bajaj S, Kumar MS, Mayur Y. An overview of tramadol and its usage in pain management and future perspective. Biomedicine & Pharmacotherapy. 2019;111:443-51.
Ali S, McGrath T, Drendel AL. An evidence-based approach to minimizing acute procedural pain in the emergency department and beyond. Pediatric emergency care. 2016;32(1):36-42.
Todd KH. A review of current and emerging approaches to pain management in the emergency department. Pain and therapy. 2017;6(2):193-202.
Cisewski DH, Motov SM. Essential pharmacologic options for acute pain management in the emergency setting. Turkish journal of emergency medicine. 2019;19(1):1-11.
Gomes T, Mamdani MM, Dhalla IA, Cornish S, Paterson JM, Juurlink DN. The burden of premature opioid‐related mortality. Addiction. 2014;109(9):1482-8.
Bérubé M, Moore L, Lauzier F, Côté C, Vogt K, Tremblay L, et al. Strategies aimed at preventing chronic opioid use in trauma and acute care surgery: a scoping review protocol. BMJ open. 2020;10(4):e035268.
Miotto K, Cho AK, Khalil MA, Blanco K, Sasaki JD, Rawson R. Trends in tramadol: pharmacology, metabolism, and misuse. Anesthesia & Analgesia. 2017;124(1):44-51.
Budd K. The role of tramadol in acute pain management. Acute Pain. 1999;2(4):189-96.
Boostani R, Derakhshan S. Tramadol induced seizure: A 3-year study. Caspian journal of internal medicine. 2012;3(3):484.
Ryan NM, Isbister GK. Tramadol overdose causes seizures and respiratory depression but serotonin toxicity appears unlikely. Clinical Toxicology. 2015;53(6):545-50.
Taghaddosinejad F, Mehrpour O, Afshari R, Seghatoleslami A, Abdollahi M, Dart RC. Factors related to seizure in tramadol poisoning and its blood concentration. Journal of medical toxicology. 2011;7(3):183.
Katalinic N, Lai R, Somogyi A, Mitchell PB, Glue P, Loo CK. Ketamine as a new treatment for depression: a review of its efficacy and adverse effects. Australian & New Zealand Journal of Psychiatry. 2013;47(8):710-27.
Thomas SH. Management of Pain in the Emergency Department. ISRN Emergency Medicine. 2013;2013:583132.
Persson J. Ketamine in pain management. CNS neuroscience & therapeutics. 2013;19(6):396-402.
Jonkman K, Dahan A, van de Donk T, Aarts L, Niesters M, van Velzen M. Ketamine for pain. F1000Res. 2017;6.
Scheppke KA, Braghiroli J, Shalaby M, Chait R. Prehospital use of im ketamine for sedation of violent and agitated patients. Western journal of emergency medicine. 2014;15(7):736.
Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg. 2010;8(5):336-41.
Alp H. The pain comparison in women uterin dilation and curettage operations. Regional Anesthesia and Pain Medicine. 2016;41(5):e119-e20.
Kilinc Y, Temizturk H, Yilmaz HL, Cil M, Leblebisatan G, Sasmaz HI. The effect of ketamine administration on pain control in painful crisis of sickle cell anemia patients during childhood: A retrospective observational study. Blood. 2018;132.
Zghidi SM, Jaoua H, Saada S, Khemiri K, Ghariani S, Laabidi S, et al. Comparison of anti hyperalgesic effect of ketamine and tramadol during perioperative period for visceral surgical laparotomy. Regional Anesthesia and Pain Medicine. 2011;36(5):E278.
Djaziri L, Ajili S, Skander R, Jaoua H, Ben Fadhel K. Comparison of anti hyperalgesic effect of ketamine and tramadol during perioperative period for visceral surgical laparotomy. Regional Anesthesia and Pain Medicine. 2013;38(5):E150.
Elkassem SA. Effects of low dose postoperative intravenous ketamine vs tramadol on postoperative patient controlled epidural analgesia after cruciate ligament reconstruction surgery. Egyptian Journal of Anaesthesia. 2008;24(2):119-28.
Khajavi MR, Sabouri SM, Moharari RS, Pourfakhr P, Najafi A, Etezadi F, et al. Multimodal analgesia with ketamine or tramadol in combination with intravenous paracetamol after renal surgery. Nephro-Urology Monthly. 2016;8(4).
Burimsittichai R, Limraksasin P, Hurst CP, Charuluxananan S. Comparison of intravenous tramadol and ketamine for prevention of catheter-related bladder discomfort after laparoscopic surgery: A randomized, placebo-controlled, double-blind study. Asian Biomedicine. 2016;10(3):253-60.
Yu C, Luo YL, Xiao SS, Li Y, Zhang Q. [Comparison of the suppressive effects of tramadol and low-dose ketamine on the patients with postoperative hyperalgesia after remifentanil-based anaesthesia]. Hua Xi Kou Qiang Yi Xue Za Zhi. 2005;23(5):404-6.
Karlow N, Schlaepfer CH, Stoll CRT, Doering M, Carpenter CR, Colditz GA, et al. A Systematic Review and Meta-analysis of Ketamine as an Alternative to Opioids for Acute Pain in the Emergency Department. Acad Emerg Med. 2018;25(10):1086-97.
Ghate G, Clark E, Vaillancourt C. Systematic review of the use of low-dose ketamine for analgesia in the emergency department. Cjem. 2018;20(1):36-45.
Lee EN, Lee JH. The Effects of Low-Dose Ketamine on Acute Pain in an Emergency Setting: A Systematic Review and Meta-Analysis. PLoS One. 2016;11(10):e0165461.
Yousefifard M, Askarian-Amiri S, Madani Neishaboori A, Sadeghi M, Saberian P, Baratloo A. Pre-hospital pain management; a systematic review of proposed guidelines. Arch Acad Emerg Med. 2019;7(1):e55.
Wang J, Xu Z, Feng Z, Ma R, Zhang X. Impact of Ketamine on Pain Management in Cesarean Section: A Systematic Review and Meta-Analysis. Pain Physician. 2020;23(2):135-48.
Riddell JM, Trummel JM, Onakpoya IJ. Low-dose ketamine in painful orthopaedic surgery: a systematic review and meta-analysis. Br J Anaesth. 2019;123(3):325-34.
García-Henares JF, Moral-Munoz JA, Salazar A, Del Pozo E. Effects of ketamine on postoperative pain after remifentanil-based anesthesia for major and minor surgery in adults: a systematic review and meta-analysis. Frontiers in pharmacology. 2018;9:921.
- Abstract Viewed: 44 times
- pdf Downloaded: 18 times