Low Dose Bolus Ketamine For Use In Sickle Cell Pain Crisis

This Phase IV, non-randomised, single-group interventional trial (n=400) will assess whether a standardised low-dose bolus ketamine pathway can improve pain management for children and young adults aged 2 to 21 years with confirmed sickle cell disease presenting to the emergency department with a vaso-occlusive pain episode. The study will compare ketamine-based acute pain treatment with historical opioid-based standard care, with the main aim of reducing hospital admission rates and improving the time to adequate pain control. Participants in the ketamine pathway will receive multimodal analgesia with acetaminophen, Toradol, lidocaine patch and heat packs, together with intravenous ketamine at 0.3 mg/kg/dose based on ideal body weight, given within 30 minutes of arrival and then every 1 hour as needed for a maximum of 3 doses. Pain scores and vital signs will be recorded before treatment and then every 30 minutes, and admission will follow if sufficient pain relief is not achieved after repeat dosing. A retrospective historical control group will represent standard care, and the study will also monitor safety concerns such as hypotension, hypertension and drowsiness.