A systematic review of ketamine for the management of vaso-occlusive pain in sickle cell disease

Pediatr Blood Cancer. 2021 Jul;68(7):e28989. doi: 10.1002/pbc.28989. Epub 2021 Mar 31.

Abstract

Vaso-occlusive episodes (VOEs) are a common complication of sickle cell disease (SCD) and a significant cause of morbidity. Managing VOE pain can be difficult and complex. Ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, has been used to manage VOE pain. This systematic literature review synthesizes research published from 2010 to 2020 on the use of ketamine infusion to decrease VOE pain. The review demonstrates that ketamine, a safe and effective treatment for VOE pain, could be considered more widely. However, the significant variability among published clinical studies with regard to dosing, timing of initiation, duration of infusion, and timing of discontinuation highlights the need for standardized ketamine infusion protocols for the management of VOE pain. We conclude with a brief discussion of key components of a potential standardized protocol supported by the literature reviewed as well as areas for future investigation.

Keywords: ketamine; pain; sickle cell disease; vaso-occlusive episode.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Anemia, Sickle Cell* / complications
  • Anemia, Sickle Cell* / drug therapy
  • Humans
  • Ketamine
  • Pain / drug therapy
  • Pain / etiology
  • Pain Management
  • Pain Measurement

Substances

  • Ketamine