Format

Send to

Choose Destination
Expert Opin Pharmacother. 2010 Oct;11(14):2417-29. doi: 10.1517/14656566.2010.515978.

Ketamine for the treatment of chronic non-cancer pain.

Author information

1
Department of Anesthesiology, Leiden University Medical Center, Leiden, The Netherlands.

Abstract

IMPORTANCE OF THE FIELD:

Worldwide the number of patients affected by chronic pain is growing and conventional treatment is often insufficient. Recently the importance of the N-methyl-d-aspartate receptor (NMDAR) in the mechanisms and maintenance of chronic pain was established. Ketamine (introduced in the 1960s as an anesthetic) is the most studied NMDAR antagonist in the treatment of various chronic pain syndromes.

AREAS COVERED IN THIS REVIEW:

The pharmacology, safety and toxicology of ketamine are discussed. Further, electronic databases were scanned for prospective, randomized controlled trials that assessed ketamine's analgesic effect in patients with chronic pain. The focus of this review is on trials published after 2008 that applied long-term intravenous infusions.

WHAT THE READER WILL GAIN:

While most studies on intravenous ketamine show acute analgesic effects, three recent trials on long-term ketamine treatment (days to weeks) demonstrate the effectiveness of ketamine in causing long-term (months) relief of chronic pain. Despite these positive results, further studies are needed on safety/toxicity issues. Other administration modes are less effective in causing long-term pain relief.

TAKE HOME MESSAGE:

There is now evidence form a limited number of studies that pain relief lasting for months is observed after long-term intravenous ketamine infusion, suggesting a modulatory effect of ketamine in the process of chronic pain, possibly via blockade of upregulated NMDAR.

PMID:
20828267
DOI:
10.1517/14656566.2010.515978
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Taylor & Francis
Loading ...
Support Center