Office of Primary Care and Area Health Education Centers (AHEC) Program

Daniel Wolfson, M.D., M.S., associate professor of emergency medicine (left), and Ajai Malhotra, M.D., professor of surgery

(FEBRUARY 5, 2025) Daniel Wolfson, M.D., M.S., associate professor of emergency medicine at the University of Vermont and the state’s EMS medical director, and Ajai Malhotra, M.D., professor of surgery and trauma medical director at UVM Medical Center, spoke with the Burlington Free Press about their research into which is better for treating pain after a severe injury: fentanyl, an opioid; or ketamine, an anesthetic.

Their research comparing the effectiveness and safety of the two medications is being funded by the U.S. Department of Defense on behalf of its soldiers but will benefit civilians alike.

“Fentanyl is commonly used to treat pain in trauma patients but can lower oxygen levels and blood pressure, potentially worsening an injured person’s condition and sometimes requiring a breathing tube,” Wolfson said in a statement. “There’s also a risk of long-term opioid dependency.”

Low-dose ketamine, on the other hand, is effective in managing pain, and may reduce the risks associated with opioids like fentanyl, but may cause side effects of its own, including hallucinations, anxiety, and a feeling of being disconnected, according to Wolfson.

“The goal is to help the military provide the best care for our injured personnel, by determining the most effective medicine to relieve the pain and also the one with the least harmful short- and long-term side effects,” Malhotra added in a statement.