Key result
Ketamine effectively improved difficult-to-manage pain and agitation in a 3-month-old infant with suspected opioid-induced hyperalgesia following high-dose fentanyl administration.
Why the study?
Opioid-induced hyperalgesia is a known adverse effect of opioids in adults, but it can be difficult to identify in infants receiving opioids during surgery.
Does ketamine improve suspected opioid-induced hyperalgesia in an infant following surgery?
Case Report (n=1)
Does ketamine improve suspected opioid-induced hyperalgesia in an infant following surgery?
Ketamine can be an effective therapeutic for suspected opioid-induced hyperalgesia in infants postoperatively.
OIH may occur in postoperative infants; this case leaves open ketamine's role pending controlled pediatric studies.
WHAT IS KNOWN AND OBJECTIVE: Opioids are commonly administered to infants having surgery. Opioid induced hyperalgesia (OIH) is a known adverse effect of opioids in adults but can be difficult to identify in infants. CASE SUMMARY: A 3-month-old received high-dose fentanyl during anorectoplasty for imperforate anus. He had signs and symptoms of OIH immediately after surgery. His pain and agitation were difficult to manage but improved after he received ketamine. WHAT IS NEW AND CONCLUSION: OIH should be considered in infants postoperatively when pain worsens despite administration of escalating doses of opioids. Ketamine can be an effective therapeutic for OIH.
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Efune et al. (2022) conducted a case report in Opioid-induced hyperalgesia (n=1). Ketamine was evaluated on Improvement in pain and agitation. Ketamine effectively improved difficult-to-manage pain and agitation in a 3-month-old infant with suspected opioid-induced hyperalgesia following high-dose fentanyl administration.
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