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Ketamine and lidocaine infusions decrease opioid consumption during vaso-occlusive crisis in adolescents with sickle

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Ketamine and lidocaine infusions may reduce opioid use in adolescents with sickle cell disease during vaso-occlusive crises. This opioid-sparing approach helps manage pain and addresses the ongoing opioid epidemic.

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Area of Science:

  • Pain Management
  • Pharmacology
  • Adolescent Medicine

Background:

  • Opioid tolerance and opioid-induced hyperalgesia (OIH) develop from recurrent opioid exposure, mediated by N-methyl-D-aspartate receptors.
  • N-methyl-D-aspartate receptor antagonists, such as ketamine and lidocaine, show potential in modulating opioid tolerance and OIH.
  • The opioid epidemic necessitates the development of opioid-sparing pain management strategies.

Purpose of the Study:

  • To evaluate the effectiveness of ketamine and/or lidocaine in reducing opioid consumption in adolescents experiencing acute pain episodes related to sickle cell disease.
  • To explore opioid-sparing analgesia for vaso-occlusive crises (VOC) in adolescents.

Main Methods:

  • Retrospective evaluation of adolescents hospitalized for VOC.
  • Comparison of opioid consumption during VOC episodes with and without ketamine and/or lidocaine infusions.
  • Patients served as their own controls by comparing treatment admissions to previous control admissions.

Main Results:

  • Ketamine and/or lidocaine infusions, as adjuncts to opioids, led to decreased daily opioid consumption in three out of four adolescent patients.
  • The study observed a potential benefit of these agents in reducing opioid exposure during VOC.

Conclusions:

  • Ketamine and/or lidocaine infusions may serve as valuable adjuncts for reducing opioid consumption in adolescents with sickle cell disease during VOC.
  • These findings support the exploration of N-methyl-D-aspartate receptor antagonists for opioid-sparing analgesia in this population.