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Akron Children’s is the first pediatric hospital in Ohio to offer innovative pain relief options

01-23-2024 (Akron, Ohio )

The Pain Center at Akron Children’s is one of the first pediatric hospitals in the United States to offer cryoanalgesia, ketamine infusions, and sphenopalatine ganglion blocks to pediatric patients for pain relief.

Ketamine is a general anesthetic commonly used to put patients to sleep before surgery. After the FDA approved its use as a general anesthetic, physicians noticed smaller doses of the drug had positive effects on chronic pain. Chronic pain is defined as pain that last for three months or longer. Ketamine is also used to treat suicidal thoughts and drug-resistant depression.

“About 10 years ago, adult pain centers started using ketamine for neuropathic, or burning pain,” said Dr. Bradley Riemenschneider, pediatric anesthesiologist and pain management specialist at Akron Children’s. “There were no pediatric centers that were doing it in the United States, So I took it upon myself to do some research, and within the past year and a half, we've been starting to treat pediatric patients with burning neuropathic pain.”

Ketamine can also be used to treat complex region pain syndrome (CRPS), fibromyalgia and chronic abdominal pain, according to Dr. Riemenschneider.

Ketamine relieves pain by several different mechanisms including blocking NMDA receptors, increasing neurotransmitters and binding to certain pain relief receptors. The drug can also increase gamma-aminobutyric acid A (GABA) in the brain, which can cause feelings of relaxation.

Dr. Riemenschneider said ketamine is an option for kids and teens who haven’t gotten results from other pain relief methods.

Patients receiving ketamine infusions at Akron Children’s do so over a period of hours at the Pain Center. Staff ask the patient to rate their pain before and after infusion.

“The goal is to get these patients off their pain medications,” said Dr. Riemenschneider. “This is for refractory pain in kids who have chronic pain and nothing else works and nothing else has helped them. This is an option.”

While ketamine affects patients differently, Dr. Riemenschneider said ketamine infusions have helped some of his patients get off their pain medications.


Akron Children’s also offers cryoanalgesia for lower extremity and chest wall pain relief. Akron Children’s is one of only a few pediatric hospitals in the country offering the procedure. The procedure involves performing a diagnostic block in the area before inserting a small needle into the skin near the painful area.

“The injection forms a little ice ball around the nerve or next to the nerve that's injured. This blocks the transmission of pain signals from that nerve to the brain,” said Dr. Riemenschneider.

The procedure can last between six to 12 months.

“The cryoanalgesia procedure can help patients if they don't have an indication for surgery and they've tried everything else with no results,” said Dr. Cassandra Hoffmann, pediatric anesthesiologist at Akron Children’s.

Sphenopalatine Ganglion Blocks

Sphenopalatine ganglion blocks are used to treat chronic daily headaches. The procedure deposits numbing medicine near the sphenopalatine ganglion in the back of the nose, blocking pain transmission and relieving headache pain. Relief can last up to 3 to 6 months.

The Pain Center at Akron Children’s is one of only a few centers in the Midwest to address the patient’s physical and emotional wellbeing in addition to their pain. In addition to pain relieving procedure, the Pain Center offers pain psychology and massage therapy services. For more information, to refer a patient or request an appointment, call 330-543-8503.


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