Low-Dose Ketamine Infusion as Adjuvant Therapy during an Acute Pain Crisis in Pediatric Patients.

Recent studies in pediatric patients have suggested that ketamine, an N-methyl-D-aspartate receptor (NMDA) antagonist, given at sub-anesthetic doses can effectively decrease pain scores, provide analgesic effects, and in some cases, reduce opioid requirements. Our study aims to assess impact of low-dose ketamine on reducing pain scores and total opioid requirements during an acute pain crisis in pediatric patients. From November 2016 to December 2018, eight patients between the ages of 2 and 17 years admitted to the pediatric intensive care unit (PICU) were treated with LDK infusions to manage severe, opioid-refractory, acute pain crises.

The prevalence of and risk factors for adverse events in children receiving patient-controlled analgesia by proxy or patient-controlled analgesia after surgery.

Background: Recent reports emphasize the risks associated with patient-controlled analgesia by proxy (PCA-P), yet data regarding such risks in children remain sparse. We compared the prevalence of clinically significant adverse events in children receiving PCA-P versus PCA, and examined factors that place children at increased risk.

Methods: The records were reviewed of opioid-naïve children, ages birth to 18 yr, who received PCA or PCA-P after surgery.