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Pain. 2002 Jun;97(3):275-81.

A single infusion of intravenous ketamine improves pain relief in patients with critical limb ischaemia: results of a double blind randomised controlled trial.

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Department of Palliative Medicine, Beatson Oncology Centre, Western Infirmary, Glasgow, Scotland G11 6NT, UK.


We report the first double blind randomised controlled trial of regular opioids and an infusion of low dose (0.6 mg/kg) intravenous ketamine compared with opioids and placebo in patients with allodynia, hyperalgesia and hyperpathia secondary to critical limb ischaemia. Thirty-five patients completed the study, 18 received regular opioids plus ketamine, while 17 received regular opioids plus placebo. Using the Brief Pain Inventory, the % pain relief that the patients in the ketamine group attributed to their medication improved significantly from 50% immediately pre-infusion to 65% 24 h post-infusion and 69% 5 days post infusion. Over the same period, the pain relief achieved by the placebo group rose from 58% pre-infusion to 56% 24 h post infusion and then 50% relief 5 days later. This was statistically significant (P<0.05) using both the t-test and the Wilcoxon Rank Sum test. The ketamine group also showed a statistically significant difference 24 h post infusion of the effect of pain on their general activity (P=0.03) and on their enjoyment of life (P=0.004). This study shows that combining a single infusion of low dose ketamine with regular opioid analgesia can result in a significant improvement in pain relief for this patient group.

[Indexed for MEDLINE]

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