The role of short-term, low dose intravenous ketamine infusion in Calciphylaxis

Ghanavatian, Shirin; James, Dominika Lipowska; Sadolf, Joshua Simon

doi:10.1007/s13730-020-00557-8

Cited by 1 publication

(2 citation statements)

References 19 publications

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“…Reported successful strategies include a combination of fentanyl/fentanyl analogs with benzodiazepines and neuropathic agents such as ketamine (level IV). 18,44 Success has also been reported for neurolytic nerve blocks using phenol 16,17 or cryoneurolysis. 15 Diagnostic nerve blocks using fast-acting agents such as lidocaine or benzocaine may be useful for determining efficacy for individual patients.…”

Section: Postoperativementioning

confidence: 99%

“…18 Low-dose ketamine infusions have been used in opioid-tolerant patients for acute pain control without adverse effects or need for dose modification due to renal impairment and therefore may be an adjunctive therapy for achieving pain control (level IV). 44 Intraoperative ketamine at lower rates (0.1-0.5 mg/kg/h) has been used for perioperative pain management of burn patients with similarly complex wounds. 38 Calciphylaxis may be triggered or exacerbated by corticosteroids and blood transfusions.…”

Section: Intraoperativementioning

confidence: 99%

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Perioperative Management of Calciphylaxis: Literature Review and Treatment Recommendations

Strand

Maloney

et al. 2022

Orthopedic Reviews

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Calciphylaxis is a serious and rare medical condition that leads to substantial clinical manifestations including pain, creating perioperative and treatment challenges. No standard treatment protocol exists nor are comprehensive guidelines available for perioperative management of patients with calciphylaxis. In this review, we evaluate existing literature (January 2000 to May 2021) with the aim to offer guidance for treating patients with this challenging disease through the perioperative period. Although no therapies are currently considered standard for treating calciphylaxis, multiple interventions are available for improving symptoms. Preoperative and intraoperative management involves monitoring and optimizing patient comorbid conditions and any possible electrolyte imbalances. Postoperative management can be challenging when potential calciphylaxis triggers are indicated, such as warfarin and corticosteroids. In addition, poor wound healing and difficult pain control are common. Therefore, a multifactorial approach to controlling postoperative pain is recommended that includes the use of nerve blocks, renal-sparing opioids, benzodiazepines, and/or ketamine. We present preoperative, intraoperative, and postoperative recommendations for treating calciphylaxis with levels of evidence when appropriate.

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Section: Postoperativementioning

confidence: 99%

Section: Intraoperativementioning

confidence: 99%