Improvement of Cyclic Vomiting Syndrome with Outpatient Ketamine Infusions.

Case report Chronic abdominal pain Cyclic vomiting syndrome Ketamine NMDA antagonist Prophylactic therapy

Journal

Case reports in gastroenterology
ISSN: 1662-0631
Titre abrégé: Case Rep Gastroenterol
Pays: Switzerland
ID NLM: 101474819

Informations de publication

Date de publication:
Historique:
received: 22 07 2020
accepted: 11 08 2020
entrez: 22 2 2021
pubmed: 23 2 2021
medline: 23 2 2021
Statut: epublish

Résumé

Cyclic vomiting syndrome (CVS) is a disorder characterized by recurrent flares of nausea and vomiting, often with significant abdominal pain, of several days duration. Although traditional prophylactic and abortive treatments for CVS are often successful, a subset of CVS patients with chronic abdominal pain may not respond as well to standard therapies. This report is the first, to our knowledge, to describe the use of outpatient ketamine infusions as therapy for refractory CVS. We describe a 63-year-old woman with history of CVS who presented with abdominal pain and recurrent episodes of nausea and vomiting. She first received ketamine during an inpatient admission for a CVS flare, with the aim of treating the abdominal pain. Given her improvement, she was offered a series of outpatient ketamine infusions, which led to a significant reduction in her symptoms. Thus, ketamine may be useful as both an abortive and prophylactic therapy in CVS. Prior reports have noted the anti-emetic effects of ketamine in the perioperative setting, and there is emerging evidence for the use of ketamine infusions for the treatment of chronic pain. However, this report is the first to describe ketamine as a potential prophylactic treatment for CVS.

Identifiants

pubmed: 33613157
doi: 10.1159/000510933
pii: crg-0015-0009
pmc: PMC7879312
doi:

Types de publication

Case Reports

Langues

eng

Pagination

9-16

Informations de copyright

Copyright © 2021 by S. Karger AG, Basel.

Déclaration de conflit d'intérêts

Anna Carpenter − no competing interests to disclose; David J. Levinthal − Advisory Board, Takeda Pharmaceuticals, Alnylam Pharmaceuticals, and InControl Medical; David G. Binion − no competing interests to disclose; Trent Emerick − no competing interests to disclose.

Références

Clin Exp Gastroenterol. 2018 Feb 26;11:77-84
pubmed: 29520160
Malays J Pathol. 2017 Apr;39(1):47-53
pubmed: 28413205
Adv Psychosom Med. 2011;30:139-161
pubmed: 21508630
Clin Transl Gastroenterol. 2016 Oct 27;7(10):e198
pubmed: 27787513
Pain. 2011 Sep;152(9):2173-2178
pubmed: 21546160
Acta Anaesthesiol Scand. 2005 Nov;49(10):1405-28
pubmed: 16223384
Can J Anaesth. 2016 Mar;63(3):311-25
pubmed: 26659198
Reg Anesth Pain Med. 2018 Jul;43(5):521-546
pubmed: 29870458
Neurogastroenterol Motil. 2019 Jun;31 Suppl 2:e13604
pubmed: 31241819
JAMA Psychiatry. 2017 Apr 1;74(4):399-405
pubmed: 28249076
J Clin Gastroenterol. 2020 Apr;54(4):327-332
pubmed: 31567626
Can J Anaesth. 2011 Oct;58(10):911-23
pubmed: 21773855
Am J Gastroenterol. 2018 May;113(5):647-659
pubmed: 29545633

Auteurs

Anna Carpenter (A)

Department of Anesthesiology, West Virginia University Ruby Memorial Hospital, Morgantown, West Virginia, USA.

David J Levinthal (DJ)

Division of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

David G Binion (DG)

Division of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

Trent Emerick (T)

Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

Classifications MeSH