P286 Best BET: in adult patients presenting to ED with severe acute pain is intranasal ketamine as effective as intravenous opiates for pain reduction?

Application for ESRA Abstract Prizes:Background and Aims This systematic review assessed whether intranasal (IN) ketamine is as effective as intravenous (IV) opiates for adults presenting to the emergency department (ED) with acute severe pain.Methods EMBASE and Medline were searched, using relevant search terms, identifying four studies relevant to our three-part question. Key findings, as well as study weaknesses, were presented in a table.Results In summary, our results indicate that IN ketamine provides pain relief comparable to IV morphine in this patient cohort, with a similar side effect profile. However, the generalisability of these findings is limited owing to the lack of uniformity in study methodologies, short-term follow up, broad exclusion criteria, sampling techniques and small sample sizes.Conclusions Intranasal ketamine provides as effective analgesia when compared to IV morphine in adult patients presenting with acute severe pain to ED. The side effect profile is largely similar and should be considered in patients in whom IV morphine is contraindicated or those who lack IV access. Further studies regarding the role of IN ketamine in this setting would be worthwhile.