Ketamine drip for acute injury pain linked to lower PTSD and anxiety scores at 6 months

The question

Does giving ketamine for pain right after a severe traumatic injury lower the chance of developing chronic pain, anxiety, depression or post-traumatic stress disorder (PTSD) in the months that follow?

What they did

Researchers at a Level 1 trauma centre enrolled 82 severely injured adults aged 18 to 64. Everyone received a patient-controlled pain pump, and participants were randomly assigned to also receive either a ketamine infusion (starting at 3 micrograms per kilogram per minute, adjustable) or an identical-looking saline drip. Neither patients nor staff knew who got which. Depression, anxiety, PTSD, pain and trauma-related quality of life were measured by questionnaire during the hospital stay and again at 1, 3 and 6 months after discharge.

What they found

Forty-four of the 82 patients (54%) were assigned to ketamine. The two groups were similar at the start in demographics, injury type and severity, and baseline quality-of-life scores. Patients who received ketamine reported significantly lower anxiety symptom severity and lower PTSD symptom scores (p < 0.05). The difference was clearest for re-experiencing symptoms, a PTSD subscale covering intrusive memories and flashbacks, at both 3 and 6 months (p < 0.05). The abstract reports no significant difference for depression or chronic pain.

The fine print

The trial was small, with 82 people at a single trauma centre, and people over 64, pregnant patients and those already using opioids long-term were excluded. The abstract gives only p values, not the actual scores or the size of the differences, so how meaningful the change was in daily life is unclear. Outcomes were self-reported questionnaires rather than clinical diagnoses, follow-up stopped at 6 months, and this summary is based on the abstract alone.

What it means

In this small trial, adding ketamine to standard pain treatment after a severe injury was associated with fewer anxiety and PTSD symptoms half a year later, particularly intrusive memories. The finding is preliminary and needs confirmation in larger trials before it could change how injured patients are treated.

Evidence grade: Moderate. A randomized, double-blind, placebo-controlled trial, but with a small sample and results reported only as p values without effect sizes or actual scores.

This summary is based on the study’s published abstract.