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The team at Cooper University Health Care is participating in a national study designed to improve the survival rate of severely injured patients, the Camden provider announced Jan. 11. 

Led by the University of Pittsburgh and funded by the Department of Defense, the Prehospital Analgesia INtervention Trial, or PAIN, is a phase-3, prehospital clinical trial that will compare the effects of two intravenous pain medications: fentanyl and low-dose ketamine. 

While fentanyl is an effective emergency pain management medication for severely injured trauma patients, according to Cooper, it can be highly fatal. According to the U.S. Centers for Disease Control and Prevention, fentanyl “is up to 50 times stronger than heroin and 100 times stronger than morphine.” Additionally, the drug can lower blood pressure and inhibit breathing reflexes, leading to respiratory problems, according to Cooper. 

Ketamine, on the other hand, relieves pain without affecting breathing reflexes. The PAIN study will assess whether low-dose ketamine is a safer option for patients, according to Cooper, which added that the medication will be given in an ambulance on the way to the hospital as a part of the study. 

Dr. Tanya Egodage, a trauma surgeon at Cooper and assistant professor of surgery at Cooper Medical School of Rowan University, will serve as the principal investigator for Cooper’s participation in the trial. 

“Both ketamine and fentanyl are used routinely by emergency medical services as standard treatment for injured patients,” Egodage said in a statement. “Fentanyl has adverse effects including lowering blood pressure and respiratory drive. Ketamine may be more beneficial to some patients and lessen the risks associated with fentanyl.”  

Who is eligible? 

Cooper said the PAIN trial is being conducted under Exception from Informed Consent (EFIC) for emergency research rules. 

“This means that since the trial requires performing a potentially life-saving procedure in people who are too injured to give permission, patients who have a traumatic injury, are in shock, and need treatment for their pain will be enrolled. Permission for continued participation will be obtained from patients once they improve, or from their family members, as soon as possible,” the medical center explained. 

Eligible patients must be transported by EMS directly from the scene of injury to Cooper University Hospital as a trauma activation and meet the following criteria: 

• Males 18 years or older and females 50 years or older with
• Compensated shock as defined by Shock Index (SI)>0.9 and
• Intravenous pain medication indicated prior to arrival at the participating trauma center

If you’d like to opt out of the study, email [email protected] to receive an opt-out “NO PAIN Study” bracelet. Cooper noted that this will not prevent trauma patients from receiving pain medication, only from participating in the study. For more information, email [email protected]. 

According to its website, the Trauma Center at Cooper University Hospital is one of only three state-designated Level I Trauma Centers verified by the American College of Surgeons. In March 2023, the center’s trauma team announced a collaboration with the U.S. Department of Homeland Security to share its expertise through a new clinical immersion training program.