Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts.
Pediatric Hematology/Oncology, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts.
Pediatr Blood Cancer. 2021 Jul;68(7):e28989. doi: 10.1002/pbc.28989. Epub 2021 Mar 31.
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.
血管阻塞性发作（VOE）是镰状细胞病（SCD）的常见并发症，也是发病率的重要原因。管理 VOE 疼痛可能具有挑战性且复杂。氯胺酮是一种 N-甲基-D-天冬氨酸（NMDA）受体拮抗剂，已被用于治疗 VOE 疼痛。这项系统文献综述综合了 2010 年至 2020 年期间发表的关于氯胺酮输注用于减轻 VOE 疼痛的研究。该综述表明，氯胺酮是一种安全有效的 VOE 疼痛治疗方法，可以更广泛地考虑。然而，已发表的临床研究在剂量、起始时间、输注持续时间和停药时间方面存在显著差异，这突出表明需要制定标准化的氯胺酮输注方案来管理 VOE 疼痛。我们以简短的讨论结束，讨论了文献综述支持的潜在标准化方案的关键组成部分以及未来研究的领域。
