Atai, Alice Gertrude and Andrew, Kwikiriza and Okobi, Okelue Edwards and Ekpa, Queen Lutina-Oloom and Ekrebe, Oghenekevwe and Koroyin, Mercy Oyeinbrakemi and Dick, Anthony I. and Bolaji, Kafayat Oluwatoyin and Adedoye, Enoobong Aderonke and Abubakar, Aisha M. T. and Okobi, Emeka Kenneth and Evbayekha, Endurance O. (2023) Oral Morphine versus Rectal Ketamine in Pain Management during Burn Wound Dressing: An Open Label Randomized Clinical Trial. Journal of Advances in Medicine and Medical Research, 35 (13). pp. 53-66. ISSN 2456-8899
![[thumbnail of Okobi35132023JAMMR99528.pdf]](http://info.submit4journal.com/style/images/fileicons/text.png)
Okobi35132023JAMMR99528.pdf - Published Version
Download (400kB)
Abstract
Background: Oral morphine has been widely used to manage children’s pain during burn wound dressing. Rectal ketamine may also be safely administered to children.
Objective: To evaluate and compare the efficacy of oral morphine vs. rectal racemic ketamine in management of pain during burn wound dressing in a pediatric population in a rural study population.
Methods: This was a randomized open-label clinical trial done in a rural hospital in Uganda. Study participants were randomly assigned to one of the treatment groups, either oral morphine or rectal ketamine, with a ratio of 1:1. Overall, we enrolled 44 participants, with 22 in each treatment arm.
Assessment of baseline vital signs, including pulse rate, blood pressure, respiratory rate, temperature, oxygen saturation (SPO2), pain assessment (using Face Legs Activity Cry Consolability [FLACC]), and sedation scores (using Richmond’s agitation and sedation scale [RASS]) among others was done. Study participants were followed up hourly for 8 hours for outcomes of interest: adequate pain management/adverse events.
Results: The mean age of the study participants was 2.56 (±1.59) years. The overall mean intra-procedural pain difference score for children who received oral morphine was 2.7 (SD±2.2) compared to 0 (SD±0) among those who received rectal ketamine, and the mean difference of 2.7 was statistically significant (p < 0.0001). Sialorrhea (hyper-salivation) was the only significant adverse event, with more occurrence in the rectal Ketamine treatment arm (n= 8, 36.3%) compared to 1 (5%) in the oral Morphine treatment arm, p = 0.009. There were no significant adverse effects noted in either treatment arm.
Conclusion: The study showed the non-inferiority of rectal ketamine over oral morphine and concluded that administration of rectal ketamine was better at pain management and safety compared to oral morphine. Rectal ketamine is associated with an increased incidence of sialorrhea compared to oral morphine.
Item Type: | Article |
---|---|
Subjects: | Eurolib Press > Medical Science |
Depositing User: | Managing Editor |
Date Deposited: | 10 May 2023 07:22 |
Last Modified: | 16 Jan 2024 04:47 |
URI: | http://info.submit4journal.com/id/eprint/1830 |