低剂量氯胺酮输注治疗镰状细胞病相关疼痛的儿科患者：病例系列。

Use of low-dose ketamine infusion for pediatric patients with sickle cell disease-related pain: a case series.

机构信息

Connecticut Children's Medical Center, University of Connecticut School of Medicine, Hartford, CT, USA.

出版信息

Clin J Pain. 2010 Feb;26(2):163-7. doi: 10.1097/AJP.0b013e3181b511ab.

DOI:10.1097/AJP.0b013e3181b511ab

PMID:20090444

Abstract

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.

摘要

目的

镰状细胞病相关疼痛难以充分治疗。血管阻塞性发作（VOE）引起的疼痛可能对大剂量静脉阿片类药物无反应。需要替代 VOE 的治疗选择。我们试图回顾我们使用小剂量氯胺酮治疗因 VOE 住院的儿童的经验。

方法

对接受氯胺酮治疗镰状细胞 VOE 的住院患者进行回顾性病历审查。收集的数据包括生命体征、疼痛评分、阿片类药物使用情况和不良事件。

结果

5 名儿童和青少年接受小剂量氯胺酮输注治疗镰状细胞相关疼痛。4 名患者在接受阿片类药物（通过患者自控镇痛给予）治疗数天无效后，作为补救干预措施接受了氯胺酮输注，1 名患者接受了氯胺酮代替阿片类药物。5 名患者中的 2 名患者似乎通过小剂量氯胺酮输注实现了临床显著的疼痛控制，而另外 1 名患者阿片类药物的使用量显著减少。