Ketamine and Acute Pain Management in Vaso-Occlusive Crisis in Sickle Cell Patients: Case Report and Literature Review

Abstract

Sickle cell disease is an autosomal recessive genetic disease by mutation of the β globin gene. The painful crisis is the clinical manifestation most frequently encountered in adults with sickle cell disease. It is manifested by the sudden onset of very intense joint or bone pain. Despite a multimodal analgesic strategy, some patients in vaso-occlusive crisis have severe pain, even after gradually increasing opioid doses. Ketamine offers an additional potentially effective therapeutic possibility in this particular clinical context. We report a case of vaso-occlusive crisis in an adult with sickle cell disease, in whom low-dose ketamine infusion resulted in clinically significant pain relief.