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Case Reports in Anesthesiology
Volume 2015 (2015), Article ID 834168, 4 pages
http://dx.doi.org/10.1155/2015/834168
Case Report

Long-Term Intravenous Ketamine for Analgesia in a Child with Severe Chronic Intestinal Graft versus Host Disease

1Anesthesiology, Morgan Stanley Children’s Hospital at Columbia University, New York, NY 10032, USA
2Anesthesiology, New York University Langone Medical Center, New York, NY 10016, USA
3Anesthesiology and Pediatrics, Morgan Stanley Children’s Hospital at Columbia University, New York, NY 10032, USA

Received 29 September 2015; Accepted 29 November 2015

Academic Editor: Jian-jun Yang

Copyright © 2015 Jennifer Busse et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Ketamine is reported to be an effective adjuvant to opioids in the treatment of refractory cancer pain; however, the use of high doses of ketamine for extended periods in pediatric patients has not been described. We present a five-year-old male with grade IV intestinal GVHD whose abdominal pain required both hydromorphone and ketamine for a period of over four months. There was no evidence of hepatotoxicity, hemorrhagic cystitis, or other adverse effects. Possible withdrawal symptoms were mild and were readily mitigated by gradually weaning ketamine.