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Syndrome of Inappropriate Antidiuretic Hormone Release During Ketamine Infusion in Complex Regional Syndrome Patient Receiving Intrathecal Baclofen: A Case Report

Shenoda, Botros B. MD, PhD, MSc*; Krevolin, Larry E. DO, FASH; Sherman, Michael MD

doi: 10.1213/XAA.0000000000001091
Case Reports

Complex regional pain syndrome (CRPS) is a severely disabling condition that typically develops after an inciting traumatic event. Ketamine infusion in subanesthetic dose provides sustained analgesia in selected cases of CRPS. In general, ketamine treatment does not significantly affect electrolyte or water balance. Here, we report a case of a CRPS patient on intrathecal baclofen pump developing syndrome of inappropriate antidiuretic hormone release (SIADH) during ketamine infusion. Prophylactic treatment with intravenous loop diuretics was successful in preventing the development of SIADH during ketamine infusion during subsequent infusions in this case.

From the *Department of Medicine

Division of Nephrology

Division of Pulmonology and Critical Care, Drexel University College of Medicine, Philadelphia, Pennsylvania.

Accepted for publication August 14, 2019.

Funding: None.

The authors declare no conflicts of interest.

Address correspondence to Michael Sherman, MD, 219 N Broad St, Philadelphia, PA 19107. Address e-mail to

Copyright © 2019 International Anesthesia Research Society
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