Is ketamine an effective alternative to parenteral opioids for the treatment of acute pain?

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Why is this study important?

Parenteral opioids are the mainstay intravenous (IV) analgesics for severe pain. However, some patients find them ineffective or intolerable, and at higher doses, they can cause respiratory depression and cardiovascular collapse. Subdissociative or low-dose (≤ 0.5 mg/kg) ketamine has been considered an equally effective parenteral analgesic option. This study systematically reviews the evidence comparing ketamine to opioids for acute pain in the emergency department (ED).

Which, if any, threats to validity are most likely to have an impact on the results and how?

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