Objectives: Sickle cell disease-related pain is difficult to treat adequately. Pain secondary to vasoocclusive episodes (VOE) may be unresponsive to high-dose intravenous opiates. Alternative treatment options for VOE are needed. We sought to review our experience with low-dose ketamine for children hospitalized with VOE.
Methods: Retrospective medical chart reviews were conducted for hospitalized patients treated with ketamine for sickle cell VOE. Data gathered included vital signs, pain scores, opiate utilization, and adverse events.
Results: Five children and adolescents received a low-dose ketamine infusion for the treatment of sickle cell-related pain. Four received the infusion in addition to opiates (delivered via patient controlled analgesia) as a rescue intervention after several days of inadequate pain relief and 1 patient received ketamine in place of opiates. Two of the 5 patients achieved what seems to be clinically significant pain control with a low-dose ketamine infusion, whereas 1 additional patient had significant reduction in opiate utilization.
Discussion: Further research into ketamine for vasoocclusive pain is warranted.
*Connecticut Children's Medical Center
†Department of Pediatrics, University of Connecticut School of Medicine, Hartford, CT
Supported by the Patrick and Catherine Weldon Donaghu Medical Research Foundation, West Hartford, CT.
Reprints: William T. Zempsky, MD, Connecticut Children's Medical Center, 282 Washington Street, Suite 5 G, Hartford, CT 06106 (e-mail: firstname.lastname@example.org).
Received for publication December 5, 2008
revised June 23, 2009
accepted June 26, 2009