Intranasal Anesthesia of the Wounded at the Prehospital Stage Using Ketamine and Dexamethasone

Summary. The purpose of the study is to compare different types of pain relief for wounded patients with traumatic shock in the prehospital period of medical care.
Materials and methods of research. The study included 168 patients, 101 of them with mine-fragmentation injuries of the lower extremities; 67 – with multiple fractures of the lower extremities received in road traffic accidents (RTA). The majority of those examined (131 patients – 78%) were men. The study included people of working age – from 19 to 59 years. All patients were diagnosed with stage II–III shock. gravity. The study did not include patients with traumatic brain injury (TBI) or patients whose level of consciousness was below 12 points on the Glasgow Coma Scale. Primary health care for the subjects was provided by medical and paramedic teams of emergency medical services (EMS) or the Disaster Medicine Service (EMS). Comparative studies were conducted in two groups of patients.
Statistical processing of the obtained data was performed using the standard software package for applied statistical analysis StatPlus 2009 Professional using Student’s t test.
Research results and their analysis. In the prehospital period of medical care as part of intensive care, 98 wounded (group 1) were injected intramuscularly with 1 ml of a 2% solution of promedol for pain relief; 70 wounded (group 2) were administered intranasally 100 mg of ketamine and 4 mg of dexamethasone. The results of the study showed that in patients of the 2nd group the analgesic effect was recorded after 5–7 minutes, in patients of the 1st group – 30–45 minutes after administration. The intensity of pain according to the visual analogue scale in patients of group 2 was two times lower than in patients of group 1.