Safety and efficacy of ketamine use in patients with vaso‐occlusive crisis: A systematic review and meta‐analysis

Introduction Sickle cell disease (SCD) is characterized by acute episodes called vaso‐occlusive crises (VOC). VOC is marked by severe pain due to blocked blood vessels by sickled cells. Ketamine has been reported to be effective and safe in managing VOC in SCD patients. Objectives/methods This review aims to determine ketamine's safety and efficacy through analysis of clinical trials and observational studies. Methods Adhering to PRISMA guidelines, this systematic review and meta‐analysis systematically searched seven databases on May 20, 2024 for randomized control trials (RCT), cohorts, and case–control studies. Results Five studies with 689 participants met the inclusion criteria. A meta‐analysis of two studies (518 observations) for the Numerical Rating Scale (NRS) pain score showed no significant difference, with a standardized mean difference (MD) of 0.23 (95% CI: −0.13 to 0.59, p = 0.21, I2 = 0%). For morphine milligram equivalent (MME), a meta‐analysis of two studies (344 observations) resulted in an MD of −0.03 (95% CI: −0.09 to 0.04, p = 0.45, I2 = 97%). However, the side effects analysis from four studies (608 observations) showed a significantly higher relative risk (RR) of 5.74 (95% CI: 2.80–11.79, p