|LETTER TO THE EDITOR
|Year : 2022 | Volume
| Issue : 1 | Page : 83
Reply to the Letter to the Editor
Mohammed S Alshahrani
Department of Emergency Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Eastern Province, Saudi Arabia
|Date of Submission||09-Jan-2022|
|Date of Acceptance||09-Jan-2022|
|Date of Web Publication||17-Jan-2022|
Mohammed S Alshahrani
Department of Emergency Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Eastern Province 31952
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Alshahrani MS. Reply to the Letter to the Editor. Saudi J Med Med Sci 2022;10:83
We thank Dr. Raghuraman MS for his valuable comments on our manuscript titled “Ketamine for sickle cell vaso-occlusive crises: A systematic review”, and would like to add clarifications.
We do acknowledge that the included studies had substantial heterogeneity in terms of comparative arms, indications for the use, dosage, and groups of patients included, which was also the reason a meta-analysis could not be performed.
The efficacy and safety of ketamine analgesic sub-dissociative dose has been proven in multiple clinical trials, but few such studies included sickle cell disease (SCD) patients with vaso-occlusive painful crises (VOC). The conclusion of our systematic review that inadequate evidence was available to confirm the efficacy and safety of ketamine was only based on that indication. Nonetheless, since the publication of the systematic review, a large randomized trial has been published that assessed the efficacy and safety of ketamine compared to morphine in adult SCD patients with VOC who presented to the emergency department. The primary outcome of this study was the mean difference in the Numerical Pain Rating scale score over 2 h: no difference was noted between the two groups. However, a meaningful pain reduction in the ketamine arm with no increase in drug-related adverse effects, led the authors to conclude that ketamine is an effective analgesic in SCD patients with VOC with a good safety profile.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Alshahrani MS, AlSulaibikh AH, ElTahan MR, AlFaraj SZ, Asonto LP, AlMulhim AA, et al. Ketamine administration for acute painful sickle cell crisis: A randomized controlled trial. Acad Emerg Med. 2021 Aug 27. doi: 10.1111/acem.14382. Online ahead of print.