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Not yet recruitingNCT07682662Updated Jul 6, 2026

Low Dose Bolus Ketamine For Use In Sickle Cell Pain Crisis

A Phase 4 interventional study of Standardized Low-dose bolus IV Ketamine within 30 minutes of arrival and every 1 hour as needed for max of 3 doses. and Standard Care (in control arm) in Vaso-Occlusive Pain Episode in Sickle Cell Disease and Sickle Cell Disease (SCD), sponsored by University of Mississippi Medical Center. Not yet recruiting at 1 site in United States. Open to participants aged 2 Years to 21 Years. Per ClinicalTrials.gov, last updated 2026-07-06.

Sponsored by University of Mississippi Medical Center · Phase 4, Interventional, and Treatment

Phase
Phase 4
Study type
Interventional
Enrollment
400
Allocation
Non-randomized
Ages
2 Years to 21 Years
Sex
All
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Study summary

The goal of this study is to learn if Ketamine works more efficiently, as compared to Opioids, for Sickle Cell Pain The main questions it aims to answer are:

Does Ketamine lower the number of times participants need to be admitted for continued pain control during a Sickle Cell Pain Crisis.

Does Ketamine decrease the amount of time it takes to reach adequate pain control/pain score improvement, as compared to Opioids.

Patients could have too low or too high blood pressure or sleepiness. Researchers will compare Ketamine to Opioids (Morphine or Dilaudid) to see if Ketamine works to treat pain enough that you do not need to be admitted to the hospital.

Participants will:

On arrival to the Children's ER for Sickle Cell Pain crisis will get Ketamine, instead of Morphine or Dilaudid, along with the typical Tylenol, Toradol, Lidocaine patch for pain control while in the ER.

During this time we will follow your reported pain scale (0-10) to monitor your pain response to the Ketamine, as well as follow rate of hospital admission.

Read the detailed description

In this study, we will be using Ketamine for pain control during a Sickle Cell Disease pain crisis, along with our current adjuncts (Tylenol, Toradol, Lidocaine patch, or heat packs), in hopes to lower the rate of admission to the hospital for continued pain control.

When presenting to the ER for pain crisis the first dose of Ketamine should be given within 30 minutes of arrival to the ER. Prior to giving Ketamine, vitals and current pain scale will be recorded in the chart. The vitals and pain scale will be rechecked every 30 minutes and documented in the chart. If a second or third dose is needed at the one-hour mark, then a second dose will be given. If after the second dose the patient does not report sufficient pain control then a third dose will be given and the patient will be admitted to the hospital.

The patient is free to opt out of the Ketamine pathway at any time and Opioids can be administered.

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Conditions studied

  • Vaso-Occlusive Pain Episode in Sickle Cell Disease
  • Sickle Cell Disease (SCD)

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Keywords

  • Pain dosed ketamine
  • pediatric sickle cell pain crisis
  • Ketamine in sickle cell pain
  • sickle cell pain
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In context

Anemia, Sickle Cell

1,134 studies on the registry are indexed under Anemia, Sickle Cell; 238 are open to participants now.

This study's planned enrollment of 400 is above the median of 40 across 769 interventional studies indexed under Anemia, Sickle Cell.

Browse Anemia, Sickle Cell studies →

Lead sponsor

University of Mississippi Medical Center is the lead sponsor of 129 studies on the registry; 20 are open to participants now.

Of its 7 completed or terminated interventional studies of FDA-regulated products, 4 (57%) have results posted.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
2 Years to 21 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Confirmed Sickle Cell Disease (any genotype), Presenting to the Emergency Department with Vaso-occlusive crisis/pain crisis, Consent obtained

Exclusion criteria

Exclusion Criteria:

  • Ketamine allergy, Severe agitation/psychosis, Pregnancy, Hemodynamic instability (as judged by physician), Increased intracranial pressure, Severe hepatic impairment, Ketamine use within the previous 24 hours, Presentation for non-VOC-related pain (i.e. fever, acute chest syndrome, stroke, traumatic injuries etc).
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Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Non-randomized
Intervention model
Single group
Masking
None (open label)
Enrollment
400 participants (estimated)

Study arms

  • Experimental
    Any patient with confirmed Sickle Cell Disease in pain crisis.

    This group will be any patient, aged 2 years until 21 years with confirmed sickle cell disease who presents to the Pediatric Emergency Department with Pain will receive multimodal pain control using Acetaminophen, Toradol, lidocaine patch, and heat packs, as well as IV Ketamine in place of Opioids.

    Drug: Standardized Low-dose bolus IV Ketamine within 30 minutes of arrival and every 1 hour as needed for max of 3 doses.

  • Other
    Retrospective Historical Control Group

    Retrospective Historical Control Group

    Other: Standard Care (in control arm)

Interventions

  • DrugStandardized Low-dose bolus IV Ketamine within 30 minutes of arrival and every 1 hour as needed for max of 3 doses.

    This dosing is based off of Ideal body weight of each patient and dosed at 0.3 mg/kg/dose.

  • OtherStandard Care (in control arm)

    Standard Care in Historical Control Group

06

What researchers measure

Primary outcomes

  1. Hospital admission rates after using a Ketamine first pathway as compared to after the use of Opioids.

    Time frame: From time of patient enrollment and IRB approval for 36 months

Secondary outcomes

  1. Emergency Department length of stay after using the Ketamine first pathway.

    Time frame: From time of patient enrollment and IRB approval until 36 months.

  2. Pain score reduction in the acute setting after using a Ketamine first pathway as compared to Opioid first pathway.

    Time frame: From time of patient enrollment and IRB approval until 36 months.

  3. Rate of repeat visits to the Emergency Department within 72 hours for pain after a Ketamine first pathway was followed.

    Time frame: From time of patient enrollment and IRB approval until 36 months.

  4. Inpatient length of stay (in number of days) for to reach adequate length of stay.

    Time frame: From time of patient enrollment and IRB approval until 36 months

  5. Adverse events experienced after using a Ketamine first pathway

    Time frame: From time of patient enrollment and IRB approval until 36 months.

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Study locations

1 site
  • University of Mississippi Medical Center, Pediatric Emergency Department
    Jackson, Mississippi 39216, United States
    • Cynthia Karlson, Ph.D. · Contactckarlson@umc.edu · 601-984-2723
    • Elizabeth Adeyemi, MD · Sub investigator
    • Laci M Edwards, MD · Sub investigator
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References and documents

Publications

  • Harris EM, Vilk E, Donado C, Williams A, Heeney MM, Solodiuk J, Greco C, Archer NM. Ketamine use for management of vaso-occlusive pain in pediatric sickle cell disease. Pediatr Blood Cancer. 2023 May;70(5):e30254. doi: 10.1002/pbc.30254. Epub 2023 Mar 2. PubMed 36861789 ↗
  • Onyebuchi CO, Chumpitazi CE, Placencia JL, Jackson AN, Jones JL, Torres L, Tubman VN. Ketamine for Pain in Sickle Cell Disease Reduces Opioid Usage. J Pain Symptom Manage. 2024 Mar;67(3):e169-e175. doi: 10.1016/j.jpainsymman.2023.11.012. Epub 2023 Nov 23. PubMed 38000561 ↗
  • Calderon Martinez E, Saji SZ, Carmona TC, et al. Ketamine for pain relief in sickle cell vaso-occlusive crises: a systematic review. Blood. 2024;144(Suppl 1):5356. doi:10.1182/blood-2024-211793. Abstract for the 66th ASH Annual Meeting
  • Kenney MO, Becerra B, Mallikarjunan A, Shah N, Smith WR. Early Initiation of Sub-Anesthetic Ketamine Infusion in Adults with Vaso-Occlusive Crises Is Associated with Greater Reduction in Sickle Cell Pain Intensity: A Single Center's Experience. Pain Med. 2022 Dec 1;23(12):2042-2049. doi: 10.1093/pm/pnac094. PubMed 35708641 ↗
  • Sener S, Eken C, Schultz CH, Serinken M, Ozsarac M. Ketamine with and without midazolam for emergency department sedation in adults: a randomized controlled trial. Ann Emerg Med. 2011 Feb;57(2):109-114.e2. doi: 10.1016/j.annemergmed.2010.09.010. PubMed 20970888 ↗
  • Laskowski K, Stirling A, McKay WP, Lim HJ. A systematic review of intravenous ketamine for postoperative analgesia. Can J Anaesth. 2011 Oct;58(10):911-23. doi: 10.1007/s12630-011-9560-0. Epub 2011 Jul 20. PubMed 21773855 ↗
  • Niesters M, Martini C, Dahan A. Ketamine for chronic pain: risks and benefits. Br J Clin Pharmacol. 2014 Feb;77(2):357-67. doi: 10.1111/bcp.12094. PubMed 23432384 ↗
  • Lovett PB, Sule HP, Lopez BL. Sickle cell disease in the emergency department. Emerg Med Clin North Am. 2014 Aug;32(3):629-47. doi: 10.1016/j.emc.2014.04.011. Epub 2014 Jun 7. PubMed 25060254 ↗
  • Yawn BP, Buchanan GR, Afenyi-Annan AN, Ballas SK, Hassell KL, James AH, Jordan L, Lanzkron SM, Lottenberg R, Savage WJ, Tanabe PJ, Ware RE, Murad MH, Goldsmith JC, Ortiz E, Fulwood R, Horton A, John-Sowah J. Management of sickle cell disease: summary of the 2014 evidence-based report by expert panel members. JAMA. 2014 Sep 10;312(10):1033-48. doi: 10.1001/jama.2014.10517. PubMed 25203083 ↗
  • Angst MS, Clark JD. Opioid-induced hyperalgesia: a qualitative systematic review. Anesthesiology. 2006 Mar;104(3):570-87. doi: 10.1097/00000542-200603000-00025. PubMed 16508405 ↗
  • Zhang D, Xu C, Manwani D, Frenette PS. Neutrophils, platelets, and inflammatory pathways at the nexus of sickle cell disease pathophysiology. Blood. 2016 Feb 18;127(7):801-9. doi: 10.1182/blood-2015-09-618538. Epub 2016 Jan 12. PubMed 26758915 ↗
  • Manwani D, Frenette PS. Vaso-occlusion in sickle cell disease: pathophysiology and novel targeted therapies. Blood. 2013 Dec 5;122(24):3892-8. doi: 10.1182/blood-2013-05-498311. Epub 2013 Sep 19. PubMed 24052549 ↗

Individual participant data

Plan to share: No — Our data will remain on a secured REDCAP. De-identified data may be shared upon reasonable request.

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jul 6, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT07682662
Responsible party
Cynthia Karlson (Professor, Vice-Chair for Pediatric Research, University of Mississippi Medical Center) — Principal investigator
First posted
Jul 6, 2026
Start date
Aug 1, 2026 (estimated)
Primary completion
Aug 31, 2029 (estimated)
Completion
Oct 1, 2029 (estimated)
Last update
Jul 6, 2026

Study contacts

Cynthia Karlson, Ph.D.
Contact
ckarlson@umc.edu
601-984-2723
John N Freeman, MD
principal investigator · University of Mississippi Medical Center

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is not yet recruiting, as verified in Jun 2026. You cannot join it, but the record below documents what was studied.

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