IRCT2015052015620N5 IRCT 2015-08-17 Vice chancellor for research, Shahid Beheshti University of Medical Sciences Pain management in patients with limb fractures Efficacy and safety of morphine-ketamine combination in comparison with morphine alone in acute pain management among patients who admitted to emergency with limb fracture 2012-12-28 anticipated 192 Complete https://irct.ir/trial/14837 interventional Randomization: Randomized, Blinding: Double blinded, Placebo: Not used, Assignment: Parallel, Purpose: Treatment, Other design features: People who refer to a referral hospital, and after confirmed fracture recruit to enroll one of the A (Morphine) or B (Morphine-Ketamine) groups by non probability sampling available technique and we will use random number table. Neither the patients nor the physicians know about the used analgesics in each group and case. 2 Condition 1: Upper limb injuries. Condition 2: Lower limb injuries. Condition 3: Pain in limb. Intervention 1: In the case of Numerical Rating Score equal or greater than 4, 0.1mg/kg bolus dose of morphine prescribe. All the variables such as vital signs, side effects, pain scores will check at consequent fifth, tenth, and 20th minutes to find any changes.A group as the control group use morphine sulfate 0.05mg/kg maintenance therapy after a bolus dose of morphine at the beginning. Adverse effects of the prescribed drugs, vital signs, and pain scores record. The process perform every 20 minutes until the Numerical Rating score fall under 4, or from beginning dose more than 2 hours past. Intervention 2: In the case of Numerical Rating Score equal or greater than 4, 0.1mg/kg bolus dose of morphine prescribe. All the variables such as vital signs, side effects, pain scores will check at consequent fifth, tenth, and 20th minutes to find any changes. In investigation group, ketamine 0.2mg/kg use with morphine 0.05mg/kg after the first bolus dose of morphine. Adverse effects of the prescribed drugs, vital signs, and pain scores record. The process perform every 20 minutes until the Numerical rating score fall under 4, or from beginning dose more than 2 hours past.