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Use of continuous intravenous ketamine for end-stage cancer pain in children

Mary Conway1, Natalie White, Candie St Jean

  • 1Hematology-Oncology Division at Connecticut Children's Medical Center, Hartford 06106, USA. mxconway@ccmckids.org

Journal of Pediatric Oncology Nursing : Official Journal of the Association of Pediatric Oncology Nurses
|February 10, 2009
PubMed

Insights

Low-dose ketamine may help manage intractable pain in children with advanced cancer. This approach can improve pain control and quality of life, allowing children to remain interactive at home.

Area of Science:

  • Palliative Care
  • Pediatric Oncology
  • Pain Management

Background:

  • Children with advanced cancer often experience intractable pain, even with high opioid doses.
  • Opioid-induced sedation can impair a child's quality of life, limiting communication and activity.
  • Effective pain management is crucial for end-of-life care in pediatric oncology.

Purpose of the Study:

  • To evaluate the efficacy of low-dose ketamine in managing intractable pain in children with end-stage cancer.
  • To assess ketamine's potential to improve pain control without increasing sedation.
  • To explore ketamine's role in enhancing quality of life for pediatric cancer patients at end of life.

Main Methods:

  • Continuous infusion of low-dose ketamine was administered to two pediatric patients with end-stage cancer.
  • Pain control and sedation levels were monitored.
  • Patient interaction and ability to participate in activities were assessed.

Main Results:

  • Low-dose ketamine provided adequate pain control in both cases.
  • Ketamine allowed children to remain interactive and at home during their final weeks.
  • Additional analgesia was achieved without significant increase in sedating effects.

Conclusions:

  • Low-dose ketamine is a potential adjunctive therapy for intractable cancer pain in children.
  • Ketamine may help prevent opioid tolerance and improve quality of life in pediatric palliative care.
  • Individualized pain management strategies are essential for end-of-life care in children with cancer.

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