Comparing ketamine and fentanyl for pain management in trauma patients

Prehospital Analgesia INtervention Trial (PAIN)

Phase 3 Interventional University of Pittsburgh · NCT05437575

This study is testing whether ketamine or fentanyl works better for managing pain in trauma patients before they reach the hospital.

Quick facts

PhasePhase 3
Study typeInterventional
Enrollment994 (estimated)
Ages18 Years and up
SexAll
SponsorUniversity of Pittsburgh Academic / other
Locations11 sites (San Diego, California and 10 other locations)
Trial IDNCT05437575 on ClinicalTrials.gov

What this trial studies

The Prehospital Analgesia INtervention trial (PAIN) is a multicenter, randomized, double-blind clinical trial designed to evaluate the effectiveness of ketamine hydrochloride versus fentanyl citrate for pain management in prehospital trauma patients experiencing compensated shock. The study will enroll approximately 994 patients over three years at select LITES Network sites. Participants will receive either ketamine or fentanyl before being transported to a trauma center, with outcomes assessed based on patient-centered measures. This trial aims to improve pain management protocols in emergency settings.

Who should consider this trial

Good fit: Ideal candidates include trauma patients with compensated shock who require intravenous pain medication.

Not a fit: Patients without IV access, those under 18 years old, or individuals with contraindications to the medications will not benefit from this study.

Why it matters

Potential benefit: If successful, this study could enhance pain management strategies for trauma patients, leading to better patient outcomes.

How similar studies have performed: Other studies have explored similar analgesic approaches, but this specific comparison of ketamine and fentanyl in prehospital settings is relatively novel.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* Transport after injury to a participating PAIN Trauma center
* 2\. Patient with compensated shock as defined by Shock Index (SI) ≥0.9 or Heart Rate (HR) ≥115.
* Intravenous pain medication indicated (CPOT≥2, NRS≥5) prior to arrival at the trauma center

Exclusion Criteria:

* No IV access
* Age \<18 years
* Females \<50 years of age
* SBP\>180 mmHg at time of enrollment
* Advanced airway management prior to first dose administration
* Known allergy to fentanyl citrate or ketamine hydrochloride
* Known prisoner
* Objection to study voiced by subject or family member at scene
* Pain treatment contraindicated by local protocol
* Wearing a "NO PAIN STUDY" bracelet

Where this trial is running

San Diego, California and 10 other locations

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Traumatic InjuryTraumaketamine hydrochloridefentanyl citrateshockpain
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.