A review of the use of ketamine in pain management
DOI:
https://doi.org/10.5055/jom.2013.0180Keywords:
ketamine, pain, reviewAbstract
Ketamine is a noncompetitive antagonist of N-methyl-D-aspartate receptor. It has been widely used in anesthesia and pain management. Ketamine has been administered via the intravenous, intramuscular, subcutaneous, oral, rectal, topical, intranasal, sublingual, epidural, and caudal routes. Ketamine improves postoperative and posttrauma pain scores and reduces opioid consumption. It has special indication for patients with opioid tolerance, acute hyperalgesia, and neuropathic pain. It also has a role in the management of chronic pain including both cancer and noncancer pain. Recreational use of ketamine is increasing as well through different routes of administration like inhalation, smoking, or intravenous injection. Long-time exposure to ketamine, especially in the abusers, may lead to serious side effects. This review is trying to define the role of ketamine in pain management.
References
Oliveira CM, Sakata RK, Issy AM, et al.: Ketamine and preemptive analgesia. Rev Bras Anestesiol. 2004; 54: 739-752.
Corssen G, Domino EF: Dissociative anesthesia: Further pharmacologic studies and first clinical experience with the phencyclidine derivative CI-581. Anesth Analg. 1966; 45: 29-40.
Aroni F, Iacovidou N, Dontas I, et al.: Pharmacological aspects and potential new clinical applications of ketamine: Reevaluation of an old drug. J Clin Pharmacol. 2009; 49: 957-964.
Morgan CJ, Curran HV; Independent Scientific Committee on Drugs: Ketamine use: A review. Addiction. 2012; 107: 27-38.
Mathew SJ, Shah A, Lapidus K, et al.: Ketamine for treatment-resistant unipolar depression: Current evidence. CNS Drugs. 2012; 26: 189-204.
Benitez-Rosario MA, Feria M, Salinas-Martin A, et al.: A retrospective comparison of the dose ratio between subcutaneous and oral ketamine. J Pain Symptom Manage. 2003; 25: 400-402.
Ryu HG, Lee CJ, Kim YT, et al.: Preemptive low-dose epidural ketamine for preventing chronic postthoracotomy pain: A prospective, double-blinded, randomized, clinical trial. Clin J Pain. 2011; 27: 304-308.
Barros GA, Miot HA, Braz AM, et al.: Topical (S)-ketamine for pain management of postherpetic neuralgia. An Bras Dermatol. 2012; 87: 504-505.
Chong C, Schug SA, Page-Sharp M, et al.: Development of a sublingual/oral formulation of ketamine for use in neuropathic pain: Preliminary findings from a three-way randomized, crossover study. Clin Drug Investig. 2009; 29: 317-324.
Weber F, Wulf H, Gruber M, et al.: S-ketamine and S-norketamine plasma concentrations after nasal and i.v. administration in anesthetized children. Paediatr Anaesth. 2004; 14: 983-988.
Reich DL, Silvay G: Ketamine: An update on the first twenty-five years of clinical experience. Can J Anaesth. 1989; 36: 186-197.
Prommer EE: Ketamine for pain: An update of uses in palliative care. J Palliat Med. 2012; 15: 474-483.
Bhutta AT: Ketamine: a controversial drug for neonates. Semin Perinatol. 2007; 31: 303-308.
Visser E, Schug SA: The role of ketamine in pain management. Biomed Pharmacother. 2006; 60: 341-348.
Zempsky WT, Loiselle KA, Corsi JM, et al.: Use of low-dose ketamine infusion for pediatric patients with sickle cell disease-related pain: A case series. Clin J Pain. 2010; 26: 163-167.
De Kock MF, Lavand’homme PM: The clinical role of NMDA receptor antagonists for the treatment of postoperative pain. Best Pract Res Clin Anaesthesiol. 2007; 21: 85-98.
Neri CM, Pestieau SR, Darbari DS: Low-dose ketamine as a potential adjuvant therapy for painful vaso-occlusive crises in sickle cell disease. Paediatr Anaesth. 2013; 23: 684-689.
Nagdeve NG, Yaddanapudi S, Pandav SS: The effect of different doses of ketamine on intraocular pressure in anesthetized children. J Pediatr Ophthalmol Strabismus. 2006; 43: 219-223.
Drayna PC, Estrada C, Wang W, et al.: Ketamine sedation is not associated with clinically meaningful elevation of intraocular pressure. Am J Emerg Med. 2012; 30: 1215-1218.
Nishimura M, Sato K: Ketamine stereoselectively inhibits rat dopamine transporter. Neurosci Lett. 1999; 274: 131-134.
Schwartzman RJ, Alexander GM, Grothusen JR: The use of ketamine in complex regional pain syndrome: Possible mechanisms. Expert Rev Neurother. 2011; 11: 719-734.
Kronenberg RH: Ketamine as an analgesic. J Pain Palliat Care Pharmacother. 2002; 16: 27-35.
Craven R: Ketamine. Anaesthesia. 2007; 62: 48-53.
Waxman K, Shoemaker WC, Lippmann M: Cardiovascular effects of anesthetic induction with ketamine. Anesth Analg. 1980; 59: 355-358.
Muir WW III, Hubbell JA: Cardiopulmonary and anesthetic effects of ketamine and its enantiomers in dogs. Am J Vet Res. 1988; 49: 530-534.
Mikesell CE, Atkinson DE, Rachman BR: Prolonged QT syndrome and sedation: A case report and a review of the literature. Pediatr Emerg Care. 2011; 27: 129-131.
Lau TT, Zed PJ: Does ketamine have a role in managing severe exacerbation of asthma in adults? Pharmacotherapy. 2001; 21: 1100-1106.
Lipton SA: Paradigm shift in neuroprotection by NMDA receptor blockade: Memantine and beyond. Nat Rev Drug Discov. 2006; 5: 160-170.
Wollmuth LP, Sobolevsky AI: Structure and gating of the glutamate receptor ion channel. Trends Neurosci. 2004; 27: 321-328.
Rodríguez-Muñoz M, Sánchez-Blázquez P, Vicente-Sánchez A, et al.: The mu-opioid receptor and the NMDA receptor associate in PAG neurons: Implications in pain control. Neuropsychopharmacology. 2012; 37: 338-349.
Orser BA, Pennefather PS, MacDonald JF: Multiple mechanisms of ketamine blockade of N-methyl-D-aspartate receptors. Anesthesiology. 1997; 86: 903-917.
Thomson AM, Girdlestone D, West DC: A local circuit neocortical synapse that operates via both NMDA and non-NMDA receptors. Br J Pharmacol. 1989; 96: 406-408.
Raha S, Gadgil P, Sankhla C, et al.: Nonparaneoplastic anti-N-methyl-D-aspartate receptor encephalitis: A case series of four children. Pediatr Neurol. 2012; 46: 246-249.
Dalmau J, Gleichman AJ, Hughes EG, et al.: Anti-NMDA-receptor encephalitis: Case series and analysis of the effects of antibodies. Lancet Neurol. 2008; 7: 1091-1098.
Chen HS, Lipton SA: The chemical biology of clinically tolerated NMDA receptor antagonists. J Neurochem. 2006; 97: 1611-1626.
Bell RF, Dahl JB, Moore RA, et al.: Perioperative ketamine for acute postoperative pain. Cochrane Database Syst Rev. 2010: CD004603.
Honarmand A, Safavi M, Karaky H: Preincisional administration of intravenous or subcutaneous infiltration of low-dose ketamine suppresses postoperative pain after appendectomy. J Pain Res. 2012; 5: 1-6.
Laskowski K, Stirling A, McKay WP, et al.: A systematic review of intravenous ketamine for postoperative analgesia. Can J Anaesth. 2011; 58: 911-923.
Mathews TJ, Churchhouse AM, Housden T, et al.: Does adding ketamine to morphine patient-controlled analgesia safely improve post-thoracotomy pain? Interact Cardiovasc Thorac Surg. 2012; 14: 194-199.
Carstensen M, M?ller AM: Adding ketamine to morphine for intravenous patient-controlled analgesia for acute postoperative pain: A qualitative review of randomized trials. Br J Anaesth. 2010; 104: 401-406.
Urban MK, Ya Deau JT, Wukovits B, et al.: Ketamine as an adjunct to postoperative pain management in opioid tolerant patients after spinal fusions: A prospective randomized trial. HSS J. 2008; 4: 62-65.
Angst MS, Clark JD: Ketamine for managing perioperative pain in opioid-dependent patients with chronic pain—A unique indication? Anesthesiology. 2010; 113: 514-515.
Hocking G, Visser EJ, Schug SA: Ketamine: Does life begin at 40? Pain: Clin Updates (IASP). 2007; 15: 1-6.
Loftus RW, Yeager MP, Clark JA, et al.: Intraoperative ketamine reduces perioperative opiate consumption in opiate-dependent patients with chronic back pain undergoing back surgery. Anesthesiology. 2010; 113: 639-646.
Joly V, Richebe P, Guignard B, et al.: Remifentanil-induced postoperative hyperalgesia and its prevention with small-dose ketamine. Anesthesiology. 2005; 10: 147-155.
Chazan S, Ekstein MP, Marouani N, et al.: Ketamine for acute and subacute pain in opioid-tolerant patients. J Opioid Manag. 2008; 4: 173-180.
Elia N, Tramér MR. Ketamine and postoperative pain—A quantitative systematic review of randomised trials. Pain. 2005; 113: 61-70.
Dahmani S, Michelet D, Abback PS, et al.: Ketamine for perioperative pain management in children: A meta-analysis of published studies. Paediatr Anaesth. 2011; 21: 636-652.
Min TJ, Kim WY, Jeong WJ, et al.: Effect of ketamine on intravenous patient-controlled analgesia using hydromorphone and ketorolac after the Nuss surgery in pediatric patients. Korean J Anesthesiol. 2012; 62: 142-147.
Ben-Ari A, Lewis MC, Davidson E.: Chronic administration of ketamine for analgesia. J Pain Palliat Care Pharmacother. 2007; 21: 7-14.
Bell RF: Ketamine for chronic non-cancer pain. Pain. 2009; 141: 210-214.
Noppers I, Niesters M, Aarts L, et al.: Ketamine for the treatment of chronic non-cancer pain. Expert Opin Pharmacother. 2010; 11: 2417-2429.
Soto E, Stewart DR, Mannes AJ, et al.: Oral ketamine in the palliative care setting: A review of the literature and case report of a patient with neurofibromatosis type 1 and glomus tumor-associated complex regional pain syndrome. Am J Hosp Palliat Care. 2012; 29: 308-317.
Hocking G, Cousins MJ. Ketamine in chronic pain management: An evidence based review. Anesth Analg. 2003; 97: 1730-1739.
Okon T: Ketamine: An introduction for the pain and palliative medicine physician. Pain Physician. 2007; 10: 493-500.
Mahoney JM, Vardaxis V, Moore JL, et al.: Topical ketamine cream in the treatment of painful diabetic neuropathy: A randomized, placebo-controlled, double-blind initial study. Pain J Am Podiatr Med Assoc. 2012; 102: 178-183.
Finch PM, Knudsen L, Drummond PD: Reduction of allodynia in patients with complex regional pain syndrome: A double-blind placebo-controlled trial of topical ketamine. Pain. 2009; 146: 18-25.
Hackworth RJ, Tokarz KA, Fowler IM, et al.: Profound pain reduction after induction of memantine treatment in two patients with severe phantom limb pain. Anesth Analg. 2008; 107: 1377-1379.
Grande LA, O’Donnell BR, Fitzgibbon DR, et al.: Ultra-low dose ketamine and memantine treatment for pain in an opioidtolerant oncology patient. Anesth Analg. 2008; 107: 1380-1383.
Bell RF, Eccleston C, Kalso EA: Ketamine as an adjuvant to opioids for cancer pain. Cochrane Database Syst Rev. 2003; 1: CD003351.
Kannan TR, Saxena A, Bhatnagar S, et al.: Oral ketamine as an adjuvant to oral morphine for neuropathic pain in cancer patients. J Pain Symptom Manage. 2002; 23: 60-65.
Salas S, Frasca M, Planchet-Barraud B, et al.: Ketamine analgesic effect by continuous intravenous infusion in refractory cancer pain: Considerations about the clinical research in palliative care. J Palliat Med. 2012; 15: 287-293.
Chen CH, Lee MH, Chen YC, et al.: Ketamine-snorting associated cystitis. J Formos Med Assoc. 2011; 110: 787-791.
Schönenberg M, Reichwald U, Domes G, et al.: Effects of peritraumatic ketamine medication on early and sustained posttraumatic stress symptoms in moderately injured accident victims. Psychopharmacology. 2005; 182: 420-425.
Morgan CJ, Muetzelfeldt L, Curran HV: Consequences of chronic ketamine self-administration upon neurocognitive function and psychological wellbeing: A 1-year longitudinal study. Addiction. 2010; 105: 121-133.
Javitt DC: Glutamatergic theories of schizophrenia. Isr J Psychiatry Relat Sci. 2010; 47: 4-16.
Covvey JR, Crawford AN, Lowe DK: Intravenous ketamine for treatment-resistant major depressive disorder. Ann Pharmacother. 2012; 46: 117-123.
Wood D, Cottrell A, Baker SC, et al.: Recreational ketamine: From pleasure to pain. BJU Int. 2011; 107: 1881-1884.
Middela S, Pearce I: Ketamine-induced vesicopathy: A literature review. Int J Clin Pract. 2011; 65: 27-30.
Chu PS, Ma WK, Wong SC, et al.: The destruction of the lower urinary tract by ketamine abuse: A new syndrome? BJU Int. 2008; 102: 1616-1622.
Bell RF: Ketamine for chronic noncancer pain: Concerns regarding toxicity. Curr Opin Support Palliat Care. 2012; 6: 183-187.
Seto WK, Ng M, Chan P, et al.: Ketamine-induced cholangiopathy: A case report. Am J Gastroenterol. 2011; 106: 1004-1005.
Sear JW: Ketamine hepato-toxicity in chronic pain management: Another example of unexpected toxicity or a predicted result from previous clinical and pre-clinical data? Pain. 2011; 152: 1946-1947.
Wai M, Chan W, Zhang A, et al.: Long-term ketamine and ketamine plus alcohol treatments produced damages in liver and kidney. Hum Exp Toxicol. 2012; 31: 877-886.
Chan WM, Xu J, Fan M, et al.: Downregulation in the human and mice cerebella after ketamine versus ketamine plus ethanol treatment. Microsc Res Tech. 2012; 75: 258-264.
Chan WM, Liang Y, Wai MS, et al.: Cardiotoxicity induced in mice by long term ketamine and ketamine plus alcohol treatment. Toxicol Lett. 2011; 207: 191-196.
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