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Evaluating the Use of Ketamine for Pain Control With Sickle Cell Crisis in Pregnancy: A Report of 2 Cases

Gimovsky, Alexis C. MD*; Fritton, Kate MD; Viscusi, Eugene MD; Roman, Amanda MD§

doi: 10.1213/XAA.0000000000000624
Case Reports: Case Report

Sickle cell crises occur frequently during pregnancy and are difficult to treat, even with high-dose opioids. Analgesia with ketamine has been suggested as an alternative, but its use during pregnancy is underreported. Two pregnant patients with uncontrolled sickle cell pain were treated with ketamine. Patient A reported no decrease in her pain, but her opioid requirements decreased. Patient B’s pain resolved during ketamine administration. No serious maternal or neonatal adverse effects occurred. Ketamine may be considered as an adjunct analgesic in pregnant patients with sickle cell pain, although prospective clinical data are needed to fully assess its efficacy.

From the *Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The George Washington University School of Medicine and Health Sciences, Washington, DC; Department of Gynecology and Obstetrics, The Johns Hopkins University School of Medicine, Baltimore, Maryland; Division of Acute Pain Management, Department of Anesthesia, Sidney Kimmel Medical College at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania; and §Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.

Accepted for publication July 12, 2017.

Funding: None.

The authors declare no conflicts of interest.

Address correspondence to Alexis C. Gimovsky, MD, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Ave, 6th Floor, Washington, DC 20037. Address e-mail to agimovsky@gmail.com.

© 2018 International Anesthesia Research Society