Reply To: Ketamine for sickle cell pain

  • Dyane Bunnell

    July 23, 2021 at 10:05 am

    We’ve been using ketamine for sickle cell pain with some pretty good opioid-sparing results. Recently we implemented a protocol of “low-dose” ketamine that allows us to administer the infusion on the acute care unit, as opposed to the ICU. For now, we are limiting these infusions to the palliative care team or the pain team. 
    We are already considering raising the max dose limit because we are finding that some of our adolescents aren’t getting the relief we’d hoped for.


    Low-dose Ketamine for Adjuvant Pain Management and Postoperative Analgesia


    0.05 mg/kg/hr – 0.3 mg/kg/hr

    (MAX DOSE 10 mg/hr)


    Not recommended for patients less than 2 years of age or less than 5 kg

    Prescribing ketamine

    Only the Pain Management or Palliative Care Service can initiate or adjust rate of low-dose ketamine infusions.


    Prescribing other opioids and benzodiazepines

    Only the Pain Management or Palliative Care Service can prescribe opioids and benzodiazepines for patients with low-dose ketamine infusions.





    Continuous cardiorespiratory and pulse oximetry monitoring.

    Infusion Device



    Carefusion AlarisTM PCA pump module

    Alaris Drug Library

    Use Ketamine infusion in Alaris Drug Library

    Vital signs


    First 24 hours start/rate increase

    HR/RR every 30 min x2, then every 2 hours

    After 24 hours

    Every 4 hours

    BP every 4 hours

    Pain Score


    Every 4 hours

    Sedation score


    First 24 hours every 2 hours

    After 24 hours every 4 hours


    Dyane Bunnell, APRN,CPON,MSN,RN
    Clinical Nurse Specialist
    Wilmington, DE
    United States
    Original Message:
    Sent: 07-01-2021 08:35 AM
    From: Elizabeth Sonnenblick
    Subject: Ketamine for sickle cell pain

    Does anybody use ketamine for Sickle cell pain?  Do you have a protocol that you would be willing to share


    Elizabeth Sonnenblick, CPHON,CPNP,MSN,RN
    St Joseph’s Regional Medical Center
    Paterson, NJ
    United States