Safety and efficacy of ketamine use in patients with vaso‐occlusive crisis: A systematic review and meta‐analysis
Abstract Introduction Sickle cell disease (SCD) is characterized by acute episodes called vaso‐occlusive crises (VOC). VOC is marked by severe pain due to blocked blood vessels by sickled cells. Ketamine has been reported to be effective and safe in managing VOC in SCD patients. Objectives/methods T...
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Wiley
2024-12-01
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| Series: | eJHaem |
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| Online Access: | https://doi.org/10.1002/jha2.1050 |
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| author | Ernesto Calderon Martinez Stephin Zachariah Saji Thomas Campos Carmona Vaidarshi Abbagoni Mohammad Salman Mishell Estefanía Llerena Vargas Suchita Mylavarapu Druvini Fernando Lakshmi Sheethal Arvapalli Nathalia Schettino Samad Nithin Karnan Camila Sanchez Cruz |
| author_facet | Ernesto Calderon Martinez Stephin Zachariah Saji Thomas Campos Carmona Vaidarshi Abbagoni Mohammad Salman Mishell Estefanía Llerena Vargas Suchita Mylavarapu Druvini Fernando Lakshmi Sheethal Arvapalli Nathalia Schettino Samad Nithin Karnan Camila Sanchez Cruz |
| author_sort | Ernesto Calderon Martinez |
| collection | DOAJ |
| description | Abstract Introduction Sickle cell disease (SCD) is characterized by acute episodes called vaso‐occlusive crises (VOC). VOC is marked by severe pain due to blocked blood vessels by sickled cells. Ketamine has been reported to be effective and safe in managing VOC in SCD patients. Objectives/methods This review aims to determine ketamine's safety and efficacy through analysis of clinical trials and observational studies. Methods Adhering to PRISMA guidelines, this systematic review and meta‐analysis systematically searched seven databases on May 20, 2024 for randomized control trials (RCT), cohorts, and case–control studies. Results Five studies with 689 participants met the inclusion criteria. A meta‐analysis of two studies (518 observations) for the Numerical Rating Scale (NRS) pain score showed no significant difference, with a standardized mean difference (MD) of 0.23 (95% CI: −0.13 to 0.59, p = 0.21, I2 = 0%). For morphine milligram equivalent (MME), a meta‐analysis of two studies (344 observations) resulted in an MD of −0.03 (95% CI: −0.09 to 0.04, p = 0.45, I2 = 97%). However, the side effects analysis from four studies (608 observations) showed a significantly higher relative risk (RR) of 5.74 (95% CI: 2.80–11.79, p < 0.0001, I2 = 0%) for mild side effects, including nausea, vomiting, and dizziness. Conclusion Ketamine qualitative synthesis shows potential for improving pain management in SCD patients during VOC, but without statistically significant differences in pain reduction. It is associated with increased mild side effects, though no severe adverse events were reported. Further research is needed to increase the sample size and power of the analysis to clarify optimal dosing and administration protocols for ketamine in this context. |
| format | Article |
| id | doaj-art-6cf3fca7e4c84f5887dd9938f99fa3bb |
| institution | Kabale University |
| issn | 2688-6146 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wiley |
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| series | eJHaem |
| spelling | doaj-art-6cf3fca7e4c84f5887dd9938f99fa3bb2024-12-16T12:47:38ZengWileyeJHaem2688-61462024-12-01561312132110.1002/jha2.1050Safety and efficacy of ketamine use in patients with vaso‐occlusive crisis: A systematic review and meta‐analysisErnesto Calderon Martinez0Stephin Zachariah Saji1Thomas Campos Carmona2Vaidarshi Abbagoni3Mohammad Salman4Mishell Estefanía Llerena Vargas5Suchita Mylavarapu6Druvini Fernando7Lakshmi Sheethal Arvapalli8Nathalia Schettino Samad9Nithin Karnan10Camila Sanchez Cruz11Biomedical Informatics Universidad Nacional Autónoma de México Mexico City MexicoOur Lady of Fatima University Valenzuela City PhilippinesUniversidad de Ciencias Médicas San José Costa RicaSt. Vincent's Medical Center Hartford HealthCare Quinnipiac University, Frank H Netter MD School of Medicine Bridgeport USAZMC Karachi PakistanUniversidad Tecnológica Equinoccial Quito EcuadorMallareddy Medical College for Women Hyderabad IndiaFaculty of Medicine University of Colombo Colombo Sri LankaGovernment Medical College Ongole Andhra Pradesh IndiaXavier University School of Medicine Woodbury New York USAK.A.P.V Government Medical College Tiruchirappalli IndiaBiomedical Informatics Universidad Nacional Autónoma de México Mexico City MexicoAbstract Introduction Sickle cell disease (SCD) is characterized by acute episodes called vaso‐occlusive crises (VOC). VOC is marked by severe pain due to blocked blood vessels by sickled cells. Ketamine has been reported to be effective and safe in managing VOC in SCD patients. Objectives/methods This review aims to determine ketamine's safety and efficacy through analysis of clinical trials and observational studies. Methods Adhering to PRISMA guidelines, this systematic review and meta‐analysis systematically searched seven databases on May 20, 2024 for randomized control trials (RCT), cohorts, and case–control studies. Results Five studies with 689 participants met the inclusion criteria. A meta‐analysis of two studies (518 observations) for the Numerical Rating Scale (NRS) pain score showed no significant difference, with a standardized mean difference (MD) of 0.23 (95% CI: −0.13 to 0.59, p = 0.21, I2 = 0%). For morphine milligram equivalent (MME), a meta‐analysis of two studies (344 observations) resulted in an MD of −0.03 (95% CI: −0.09 to 0.04, p = 0.45, I2 = 97%). However, the side effects analysis from four studies (608 observations) showed a significantly higher relative risk (RR) of 5.74 (95% CI: 2.80–11.79, p < 0.0001, I2 = 0%) for mild side effects, including nausea, vomiting, and dizziness. Conclusion Ketamine qualitative synthesis shows potential for improving pain management in SCD patients during VOC, but without statistically significant differences in pain reduction. It is associated with increased mild side effects, though no severe adverse events were reported. Further research is needed to increase the sample size and power of the analysis to clarify optimal dosing and administration protocols for ketamine in this context.https://doi.org/10.1002/jha2.1050ketamineopioidspain managementsickle cell disease (SCD)vaso‐occlusive crisis (VOC) |
| spellingShingle | Ernesto Calderon Martinez Stephin Zachariah Saji Thomas Campos Carmona Vaidarshi Abbagoni Mohammad Salman Mishell Estefanía Llerena Vargas Suchita Mylavarapu Druvini Fernando Lakshmi Sheethal Arvapalli Nathalia Schettino Samad Nithin Karnan Camila Sanchez Cruz Safety and efficacy of ketamine use in patients with vaso‐occlusive crisis: A systematic review and meta‐analysis eJHaem ketamine opioids pain management sickle cell disease (SCD) vaso‐occlusive crisis (VOC) |
| title | Safety and efficacy of ketamine use in patients with vaso‐occlusive crisis: A systematic review and meta‐analysis |
| title_full | Safety and efficacy of ketamine use in patients with vaso‐occlusive crisis: A systematic review and meta‐analysis |
| title_fullStr | Safety and efficacy of ketamine use in patients with vaso‐occlusive crisis: A systematic review and meta‐analysis |
| title_full_unstemmed | Safety and efficacy of ketamine use in patients with vaso‐occlusive crisis: A systematic review and meta‐analysis |
| title_short | Safety and efficacy of ketamine use in patients with vaso‐occlusive crisis: A systematic review and meta‐analysis |
| title_sort | safety and efficacy of ketamine use in patients with vaso occlusive crisis a systematic review and meta analysis |
| topic | ketamine opioids pain management sickle cell disease (SCD) vaso‐occlusive crisis (VOC) |
| url | https://doi.org/10.1002/jha2.1050 |
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