Guthrie to Participate in Department of Defense Trauma Management Study

Despite its reputation as a lethal substance contributing to the current opioid crisis, fentanyl plays a crucial role in the medical field, managing acute pain effectively for severely injured trauma patients.

The Guthrie Clinic announced today that it is one of nine health care sites in the country participating in the University of Pittsburgh-led Prehospital Analgesia INtervention (PAIN) Trial, to determine if giving fentanyl or low dose ketamine to trauma patients with pain in mild shock affects health outcomes. While fentanyl offers substantial relief from intense pain, it may cause a reduction in blood pressure and disrupt normal breathing patterns, potentially resulting in respiratory issues.

The 4-year, multi-center study began in the fall of 2023 and assesses if ketamine, an anesthetic that relieves pain without affecting breathing reflexes, can be a safer option for patients. The medication will be given in an ambulance on the way to the hospital.

“Both ketamine and fentanyl are used by Emergency Medical Services as standard treatment for pain management,” said Dr. Jason Sperry, Professor of Surgery at Pitt, UPMC trauma surgeon and a principal investigator for the study. “Fentanyl is associated with addiction and low blood pressure. Ketamine may have some complications, including hallucinations, anxiety, and a feeling of disconnectedness, but may be more beneficial to some patients and lessen exposure and risks to opioids,” Dr. Sperry added. “The goal is to help the military to provide the best care for injured personnel, help determine the best pain medicine and determine what are the best short and long-term outcomes when comparing these medications,’ he said.

The trial is part of the Linking Investigations in Trauma and Emergency Services (LITES) Network, which conducts research funded by the US Department of Defense, to inform clinical practice guidelines and update the existing standards for the care of traumatic injuries. The study will enroll about 1000 random trauma patients (randomizing them to fentanyl or ketamine) from nine health care sites in the LITES Network in the United States. Patients are expected to participate in the study for up to six months.

“Guthrie is proud to participate in the PAIN Trial. Our commitment to advancing health care and patient safety aligns perfectly with the goals of this important study,” said Dr. Chris Berry, Guthrie emergency medicine physician and site primary investigator for the study. “As a Level 1 Trauma Center, Robert Packer Hospital is uniquely positioned to contribute valuable insights and data to this research. Our participation underscores Guthrie’s commitment to improving patient outcomes and advancing the field of emergency medicine," he added.

Anyone may opt-out of the study by contacting the research team at 1-800-664-0557 or email PAINStudy@edc.pitt.edu to receive an opt out “NO PAIN Study” bracelet. For more information visit ClincialTrials.gov and refer to NCT05437575. Opting out will not prevent trauma patients from receiving pain medication, only from enrollment in the study.

This research is supported by DoD contract W81XWH-16-D-0024 W81XWH-19-F-0539. Any opinions or recommendations expressed in this material are those of the author(s) and do not necessarily reflect the views of the Department of Defense.