{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T11:31:08Z","timestamp":1771327868856,"version":"3.50.1"},"reference-count":17,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2006,8,14]],"date-time":"2006-08-14T00:00:00Z","timestamp":1155513600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2006,11]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p><jats:bold>Background:\u2002<\/jats:bold> Toxic megacolon is a life\u2010threatening complication of ulcerative colitis (UC) characterized by systemic toxicity, loss of blood per rectum and severe pain. Pain management is challenging in these patients because nonsteroidal anti\u2010inflammatory drugs may exacerbate bleeding and opioids are contraindicated because they adversely affect bowel peristalsis causing an increased risk of colonic perforation.<\/jats:p><jats:p><jats:bold>Methods:\u2002<\/jats:bold> We describe three episodes of fulminating UC in two children in whom ketamine analgesia was used. Our protocol for a low\u2010dose continuous ketamine infusion with either nurse\u2010controlled analgesia (NCA) or patient\u2010controlled analgesia (PCA) bolus administration is presented and a review of the literature regarding the use of ketamine analgesia in children is discussed.<\/jats:p><jats:p><jats:bold>Results:\u2002<\/jats:bold> Low\u2010dose ketamine N\/PCA with a continuous background infusion provided satisfactory analgesia and none of our children reported adverse effects.<\/jats:p><jats:p><jats:bold>Conclusions:\u2002<\/jats:bold> We have demonstrated the safe and effective use of ketamine analgesia in children with toxic megacolon, a condition in which the child is in severe pain and morphine is contraindicated.<\/jats:p>","DOI":"10.1111\/j.1460-9592.2006.01913.x","type":"journal-article","created":{"date-parts":[[2006,8,14]],"date-time":"2006-08-14T13:31:26Z","timestamp":1155562286000},"page":"1148-1152","source":"Crossref","is-referenced-by-count":14,"title":["Pain management in fulminating ulcerative colitis"],"prefix":"10.1111","volume":"16","author":[{"given":"MICHELLE","family":"WHITE","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"NEIL","family":"SHAH","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"KEITH","family":"LINDLEY","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"ADRIAN","family":"LLOYD\u2010THOMAS","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"MARK","family":"THOMAS","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2006,8,14]]},"reference":[{"key":"e_1_2_4_2_2","first-page":"825","volume-title":"Pediatric Gastrointestinal Disease","author":"Leichtner AM","year":"2005"},{"key":"e_1_2_4_3_2","volume-title":"Guidelines for the Management of Inflammatory Bowel Disease","author":"British Society of Gastroenterology","year":"2004"},{"key":"e_1_2_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(95)00073-2"},{"key":"e_1_2_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(91)90100-C"},{"key":"e_1_2_4_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(95)00022-K"},{"key":"e_1_2_4_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.1997.tb04854.x"},{"key":"e_1_2_4_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF03019730"},{"key":"e_1_2_4_9_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1460-9592.2003.01090.x"},{"key":"e_1_2_4_10_2","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-6576.2003.00111.x"},{"key":"e_1_2_4_11_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1460-9592.2003.01049.x"},{"key":"e_1_2_4_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/00043426-200112000-00013"},{"key":"e_1_2_4_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.mph.0000140656.96085.2c"},{"key":"e_1_2_4_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199608000-00012"},{"key":"e_1_2_4_15_2","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1994.03950030035004"},{"key":"e_1_2_4_16_2","doi-asserted-by":"publisher","DOI":"10.1213\/01.ANE.0000118109.12855.07"},{"key":"e_1_2_4_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2004.09.036"},{"key":"e_1_2_4_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD003351"}],"container-title":["Pediatric Anesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1460-9592.2006.01913.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1460-9592.2006.01913.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T10:00:58Z","timestamp":1696932058000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1460-9592.2006.01913.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,8,14]]},"references-count":17,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2006,11]]}},"alternative-id":["10.1111\/j.1460-9592.2006.01913.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1460-9592.2006.01913.x","archive":["Portico"],"relation":{},"ISSN":["1155-5645","1460-9592"],"issn-type":[{"value":"1155-5645","type":"print"},{"value":"1460-9592","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,8,14]]}}}