Ketamine in the management of refractory cancer pain
DOI:
https://doi.org/10.51481/amc.v48i2.242Keywords:
pain, cancer, analgesia, ketamineAbstract
Patients with cancer suffer moderate to severe painduring the course of their disease, mainly during the terminal phase. The World Health Organization Pain Relief Ladder has been used as a therapeutic guide for the treatment of these patients, which uses 3 kinds of drugs: opioids,non steroidal anti-inflammatory drugs, and adjuvants.Ketamine is one of the latter; it is a phencyclidine derivativethat interacts with N-methyl-D-aspartate (NMDA) recep-tors. Traditionally it has been used as an anesthesia induction drug, and subanesthetic doses are used for relief of painrefractory to opioids.
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References
Organización Mundial de la Salud. National cancer control pro-grammes: policies and manage trial guidelines. Ginebra, 2002.
Organización Mundial de la Salud. Adherencia a los tratamientos alargo plazo: pruebas para la acción. Ginebra, 2003.
Fine P. Low-dose ketamine in the management of opioid resistantterminal cancer pain. J Pain Symptom Manage. 1999;17:296-300.
Patterson D, Shahar S. Burn pain. In: Loeser J, et al., editors.Bonica's management of pain. Philadelphia: Lippincott, Williams andWilkins; 2001. pp. 781-7.
Weinbroum A. A single small dose of postoperative ketamine pro-vides rapid and sustained improvement in morphine analgesia in thepresence of morphine resistant pain. Anesth Analg. 2003;96:789-95.
Bell R, Dahl J, Moore R, Kalso E. Peri-operative ketamine for acutepost-operative pain: a quantitative and qualitative systematic reviewActa Anaesthesiol Scand. 2005;49:1405-28.
Kafali H, Aldemir B, Kaygusuz K, Gursoy S, Kunt N. Small-doseketamine decreases postoperative morphine requirements. Eur JAnaesthesiol. 2004 Nov;21:916-7.
Fine P. Ketamine: From Anesthesia to Palliative Care. AAHPMBulletin 2003, 3: 1-6.
Richebe P, Rivat C, Laulin JP, Maurette P, Simonnet G. Ketamineimproves the management of exaggerated postoperative painobserved in perioperative fentanyl-treated rats. Anesthesiology.2005;102:421-8.
Jackson K, Ashby M, Martin P.: ""Burst"" Ketamine for refractory can-cer pain: an open-label audit of 39 patients. J Pain Symptom Manage2001; 22: 834-42.
Pasero C, McCaffery M. Pain control: ketamine: low doses may pro-vide relief for some painful conditions. Am J Nurs. 2005;105:60-4.
Langsjo J, Maksimow A, Salmi E, Kaisti K, Aalto S, Oikonen V,Hinkka S, Aantaa R, Sipila H, Viljanen T, Parkkola R, Scheinin H. S-ketamine anesthesia increases cerebral blood flow in excess of themetabolic needs in humans. Anesthesiology. 2005 ;103:258-68.
Shimoyama M, Shimoyama N, Gorman A, Elliot R, Inturrici C. OralKetamine is antinociceptive in the rat: the role of norketamine. Pain1999; 81: 85-93.
Krystal J, Karper L, Benett A. Interactive effects of subanestetic ket-amine and subhypnotic lorazepam in humans. Psichopharmacology1998; 38: 203-19.
Fisher K, Coderre T, Hagen N. Targeting the N-Methyl-D-Aspartatereceptor for chronic pain management: preclinical animal studies,recent clinical experience and future research directions. J PainSymptom Manage 2000; 20:358-73.
Annetta M, Iemma D, Garisto C, Tafani C, Proietti R. Ketamine: newindications for an old drug. Curr Drug Targets. 2005;6:789-94.
Lynch M, Clark A, Sawynok J, Sullivan M. Topical amitriptyline andketamine in neuropathic pain syndromes: an open-label study. J Pain.2005; 6:644-9.
Reves J, et al. Intravenous nonopioid anesthetics. In: Miller R, editor.Miller's anesthesia. Philadelphia: Hanley and Belfus; 2005. p.317-78.
Larcher A, Laulin J, Celerier E, Le Moal M, Simonnet G. Acutetolerance associated with a single opiate administration: involvementof N-methyl-D-aspartate-dependent pain facilitatory systems.Neuroscience 1998; 84:583-9.
Akin Takmaz S, Inan N, Gunal S, Kaymak C, Sakalli M, Dikmen B.Ketamine combined with morphine for the management of cancerpain in a patient with meperidine tolerance and addiction. Agri. 2005Jul;17:44-7.
Anghelescu DL, Oakes LL. Ketamine use for reduction of opioid tol-erance in a 5-year-old girl with end-stage abdominal neuroblastoma.J Pain Symptom Manage. 2005;30:1-3.
Fitzgibbon EJ, Viola R. Parenteral ketamine as an analgesic adjuvantfor severe pain: development and retrospective audit of a protocol fora palliative care unit. J Palliat Med. 2005;8:49-57.
Lossignol DA, Obiols-Portis M, Body JJ. Successful use of ketaminefor intractable cancer pain. Support Care Cancer. 2005;13:188-93.
Slatkin NE, Rhiner M. Ketamine in the treatment of refractory cancerpain: case report, rationale, and methodology. J Support Oncol.2003;1:287-93.
Kotlinska-Lemieszek A, Luczak J. Subanesthetic ketamine: an essen-tial adjuvant for intractable cancer pain. J Pain Symptom Manage.2004;28:100-2.
Rae F, Eccleston C, Kalso E. Ketamine as adjuvant to opioids forcancer pain. A Qualitative Systematic Review. J Pain SymptomManage 2003; 26:867-875.64Figura 1. Receptor NMDA. Modificado de www.SNCforum.com
Thogulava R, Saxena A., Sushma B. Oral Ketamine as an adjuvant tooral morphine for neuropathic pain in cancer patients. J PainSymptom Manage. 2002;23:60-65
Kannan T. Oral ketamine as an adjuvant to oral morphine for neuro-pathic pain in cancer patients. J Pain Symptom Manage2002;23:60-5.
Friedman R., Li V., Keuppers F., Atkinson G. Oral Ketamine in hepa-tocellular carcinoma. Pain medicine 2000; 1: 181-182.
McDonnell F., Sloan J., Hamann S: Advances in cancer pain manage-ment. Current Pain Headache Rep 5: 265-71, 2001.
Ban C,Tsui H, Dawn D, Sunil D, Malherbe S, Intravenous KetamineInfusion as an Adjuvant to Morphine in a 2-Year-Old With SevereCancer Pain From Metastatic Neuroblastoma. J Pediatr HematolOncol. 2004;26:678-680.
Mercadante S, Arcuri E, Tirelli W. Analgesic Effect of IntravenousKetamine in Cancer Patients on Morphine Therapy: A Randomized,Controlled, Double-Blind, Crossover, Double-Dose Study. J PainSymptom Manage. 2000; 20:246-252.
Yang C, Wong C, Chang J. Intrathecal ketamine reduces morphinerequirements in patients with terminal cancer pain. Canadian J ofAnaesthesia 1996; 43:379-83.
Carr D, Goudas L, Denmana W, BroOkoff D, Staats P, BrennenL,Green G, Albine R, Hamilton D, Rogers M, Firestone L, Alvin R,Mermelstein F. Safety and efficacy of intranasal ketamine for thetreatment of breakthrough pain in patients with chronic pain: a ran-domized,double-blind, placebo-controlled, crossover study. Pain2004;108: 17-27.
Gammaitoni A, Gallagher R, Welz-Bosna M. Topical ketamine gel:possible role in treating neuropathic pain. Pain Med. 2000;1:97-100.
Yaster M. General anesthesia. In: Yaster M, et al., editors. Pediatricpain management and sedation handbook. St. Louis: Mosby-Yearbook; 1997. p. 376.
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