Low-Dose Oral Ketamine for Procedural Analgesia in Pediatric Cancer Patients Undergoing Lumbar Puncture at a Resource-Limited Cancer Hospital in India

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Low-Dose Oral Ketamine for Procedural Analgesia in Pediatric Cancer Patients Undergoing Lumbar Puncture at a Resource-Limited Cancer Hospital in India. / Rayala, Spandana; Bäckdahl, Tim; Reddy, Naresh; Jacob, Jean; Gebre-Medhin, Erik; Karonen, Emil; Palat, Gayatri; Sinha, Sudha; Schyman, Tommy; Wiebe, Thomas; Brun, Eva; Segerlantz, Mikael.

I: Journal of Palliative Medicine, Vol. 22, Nr. 11, 25.10.2019, s. 1357-1363.

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Rayala, Spandana ; Bäckdahl, Tim ; Reddy, Naresh ; Jacob, Jean ; Gebre-Medhin, Erik ; Karonen, Emil ; Palat, Gayatri ; Sinha, Sudha ; Schyman, Tommy ; Wiebe, Thomas ; Brun, Eva ; Segerlantz, Mikael. / Low-Dose Oral Ketamine for Procedural Analgesia in Pediatric Cancer Patients Undergoing Lumbar Puncture at a Resource-Limited Cancer Hospital in India. I: Journal of Palliative Medicine. 2019 ; Vol. 22, Nr. 11. s. 1357-1363.

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TY - JOUR

T1 - Low-Dose Oral Ketamine for Procedural Analgesia in Pediatric Cancer Patients Undergoing Lumbar Puncture at a Resource-Limited Cancer Hospital in India

AU - Rayala, Spandana

AU - Bäckdahl, Tim

AU - Reddy, Naresh

AU - Jacob, Jean

AU - Gebre-Medhin, Erik

AU - Karonen, Emil

AU - Palat, Gayatri

AU - Sinha, Sudha

AU - Schyman, Tommy

AU - Wiebe, Thomas

AU - Brun, Eva

AU - Segerlantz, Mikael

PY - 2019/10/25

Y1 - 2019/10/25

N2 - Aim: The aim of this study was to evaluate the therapeutic efficacy and safety profile of orally administered low-dose ketamine for procedural pain management in pediatric cancer patients undergoing lumbar puncture (LP) in a resource-limited hospital setting. Methods: Patients between 4 and 15 years of age, with leukemia, undergoing LP were asked to participate. The study was designed as a two-armed blinded placebo-controlled trial where 0.8 mg/kg (bodyweight) of ketamine mixed in juice was given 30 minutes before the procedure to Group K (ketamine) compared with placebo, only juice, to Group P (placebo). In addition, topical analgesia (EMLA®) was given according to established standard of care. Patients and caregivers assessed the pain using the Wong-Baker Faces Pain Rating Scale. Results: A total number of 52 patients, equally distributed between Group K and Group P, were included in the study. The placebo-controlled group had significantly higher self-reported pain score than the group receiving ketamine (p = 0.046), as well as in caregiver-assessed pain (p = 0.033). Only three incidents of mild adverse effects were reported. Conclusion: Low-dose oral ketamine can be safely administered for procedural analgesia in pediatric cancer patients undergoing LP in a resource-limited hospital setting and have significant pain-reducing effect compared with placebo.

AB - Aim: The aim of this study was to evaluate the therapeutic efficacy and safety profile of orally administered low-dose ketamine for procedural pain management in pediatric cancer patients undergoing lumbar puncture (LP) in a resource-limited hospital setting. Methods: Patients between 4 and 15 years of age, with leukemia, undergoing LP were asked to participate. The study was designed as a two-armed blinded placebo-controlled trial where 0.8 mg/kg (bodyweight) of ketamine mixed in juice was given 30 minutes before the procedure to Group K (ketamine) compared with placebo, only juice, to Group P (placebo). In addition, topical analgesia (EMLA®) was given according to established standard of care. Patients and caregivers assessed the pain using the Wong-Baker Faces Pain Rating Scale. Results: A total number of 52 patients, equally distributed between Group K and Group P, were included in the study. The placebo-controlled group had significantly higher self-reported pain score than the group receiving ketamine (p = 0.046), as well as in caregiver-assessed pain (p = 0.033). Only three incidents of mild adverse effects were reported. Conclusion: Low-dose oral ketamine can be safely administered for procedural analgesia in pediatric cancer patients undergoing LP in a resource-limited hospital setting and have significant pain-reducing effect compared with placebo.

U2 - 10.1089/jpm.2018.0667

DO - 10.1089/jpm.2018.0667

M3 - Article

VL - 22

SP - 1357

EP - 1363

JO - Journal of Palliative Medicine

JF - Journal of Palliative Medicine

SN - 1096-6218

IS - 11

ER -