• Ashley Davis, Catsim Fassassi, Daniel Dove, Jefferson Drapkin, Antonios Likourezos, Ankit Gohel, Patrizia Favale, Rukhsana Hossain, Mahlaqa Butt, Louis Gerges, and Sergey Motov.
• Department of Emergency Medicine, Maimonides Medical Center, Brooklyn, New York.
• J Emerg Med. 2022 Jun 1; 62 (6): 750-759.

BackgroundMusculoskeletal pain (MSK) affects one out of three adults and is the most common source of significant long-term pain, physical disability, and under-treatment in the emergency department (ED).ObjectiveWe aimed to assess the analgesic efficacy of a combination of oral VTS-Aspirin® (Vitalis Analgesics, New York, NY) and ketamine in managing acute MSK pain in adult ED patients.MethodsThis was a prospective, proof-of-concept, single-arm, pilot study evaluating the analgesic efficacy of a single dose of oral combination of VTS-Aspirin and ketamine in adult ED patients with acute moderate-to-severe MSK pain. The primary outcome included the difference in pain scores on an 11-point numeric pain rating scale at 60 min. Secondary outcomes included the need for rescue analgesia, the occurrence of adverse events at 60 min, and a change in pain scores at 120 min.ResultsWe enrolled 25 subjects in the study. The mean baseline pain score was 8.6 and the mean pain score at 60 min decreased to 4.8. The oral ketamine dose ranged from 24 mg to 50 mg, with a mean dose of 37.8 mg. No clinically concerning changes in vital signs were noted. No serious adverse events occurred in any of the subjects. Majority of adverse effects were transient and weak in intensity.ConclusionWe demonstrated that administration of an oral combination of VTS-Aspirin and ketamine to adult ED patients with acute MSK pain resulted in clinically significant pain relief in 80% of enrolled subjects.Copyright © 2022. Published by Elsevier Inc.

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