NCT06835504 · Columbia University
Morphine or Ketamine for Analgesia
(MoKA)
What this study is about
Pain is common in children presenting to the emergency department but is frequently undertreated, leading to both short- and long-term consequences. Morphine is the standard treatment for children with moderate to severe acute pain, but its use is associated with serious side effects and caregiver and clinician concerns related to opioid administration.
View original scientific description
Pain is common in children presenting to the emergency department but is frequently undertreated, leading to both short- and long-term consequences. Morphine is the standard treatment for children with moderate to severe acute pain, but its use is associated with serious side effects and caregiver and clinician concerns related to opioid administration.
Interventions
DRUG
Ketamine hydrochloride
Sub-dissociative ketamine, IV
DRUG
Morphine sulphate
Morphine, IV
Primary outcome measures
Pain intensity
Time frame: Up to 240 minutes after completion of study drug administration or until a terminal event occurs
Self-reported pain intensity measured using the Verbal Numerical Rating Scale (VNRS). Scored from 0 to 10. A higher score indicates a worse outcome.
Cardiopulmonary adverse events requiring an intervention
Time frame: Up to 120 minutes after completion of study drug administration or until a terminal event occurs
Cardiopulmonary adverse events (e.g., hypoxia, respiratory depression, hypotension) requiring an intervention (e.g., isotonic fluid bolus; vasopressor; chest compression; naloxone; supplemental oxygen; non-invasive positive pressure ventilation; bag-valve-mask ventilation; tracheal intubation)
Pain-related function
Time frame: Days 1, 2,3, and 7 after discharge.
Pain intensity and related functional limitations due to pain, measured using the Parents' Postoperative Pain Measure (PPPM). Scored from 0 to 10. A higher score indicates a worse outcome.
Post-traumatic stress
Time frame: Baseline (at time of enrollment) and days 7, 30, 90 and 180 after discharge.
Stress related to the pain experienced measured using the University of California Los Angeles Post-Traumatic Stress Disorder (UCLA PTSD). Scored from 0 to 80. A higher score indicates a worse outcome.
Who can participate
This study lists these criteria on ClinicalTrials.gov. A study coordinator reviews eligibility during screening — this page does not determine whether you qualify.
Inclusion criteria
- Abdominal pain or isolated long-bone extremity fracture (suspected or proven) 2. Self-reported pain score of ≥ 6/10 3. Requires IV morphine for analgesia as determined by the treating physician
Exclusion criteria
- Weight \> 82.4 kg 2. Known allergy/contraindication to morphine or ketamine 3. Antecedent receipt of ketamine related to presenting complaint 4. Inability to use self-report measures of pain or questionnaires 5. Chronic disease associated with pain 6. Chronic pain condition requiring use of opioids as outpatient 7. Hemodynamic instability or critical illness per treating physician 8. Altered mental state (e.g., GCS , 14 or clinical intoxication) 9. Known history of schizophrenia, liver or kidney problems, or osteogenesis imperfecta 10. Concern for open fracture, neurovascular compromise, or compartment syndrome 11. Injuries in addition to the extremity injury (e.g., head, neck, abdomen) 12. Known or reported pregnancy 13. Does not speak English or
Where
- Los Angeles, California
- Sacramento, California
- Wilmington, Delaware
- Atlanta, Georgia
- New York, New York
- Pittsburgh, Pennsylvania
- Seattle, Washington
- Milwaukee, Wisconsin
Collaborators
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institute of Neurological Disorders and Stroke (NINDS)
Related conditions & keywords
Frequently asked questions
What is a clinical trial?
A clinical trial is a research study that tests new medical treatments, drugs, devices, or procedures to determine their safety and effectiveness. Trials are carefully designed and monitored to protect participants while advancing medical knowledge.
Is it safe to participate?
Clinical trials follow strict safety guidelines and ethical standards. Trials must be reviewed and approved, and participants are closely monitored by medical professionals throughout the study. You can withdraw at any time if you choose.
Will I be compensated?
Many clinical trials offer compensation for your time, travel expenses, and inconvenience. The specific compensation varies by study and will be discussed during the screening process. All study-related medical care is typically provided at no cost to participants.
Will I receive a placebo instead of treatment?
When effective treatment exists, participants typically receive either the standard treatment plus the study intervention, or the standard treatment plus placebo. You would not be denied effective care. Placebos are primarily used when no proven treatment is available, or in addition to standard care. Your trial consent form will clearly explain what treatments you may receive.
Can I leave a trial if I change my mind?
Absolutely. Participation in clinical trials is completely voluntary. You have the right to withdraw from the study at any time, for any reason, without penalty or loss of benefits to which you are otherwise entitled.
How long does a clinical trial last?
Trial duration varies widely depending on the study design and purpose. Some trials last just a few weeks, while others may continue for months or years. The study coordinator will provide specific timeline information during your screening call.
Data: ClinicalTrials.gov · synced Oct 20, 2026 · Source of record for eligibility and locations