“Burst” Ketamine for Refractory Cancer Pain: An Open-Label Audit of 39 Patients Kate Jackson, MB BS, DTM&H, FRCA, FAChPM, Michael Ashby, MB

Title

“Burst” Ketamine for Refractory Cancer Pain: An Open-Label Audit of 39 Patients Kate Jackson, MB BS, DTM&H, FRCA, FAChPM, Michael Ashby, MB

Creator

Jackson K; Ashby M; Martin P; PallMed Dip; Pisasale M; Brumley D; Hayes B

Publisher

Journal Of Pain And Symptom Management

Date

2001

Description

The results of a novel approach to the use of ketamine in refractory cancer pain are reported. In this prospective, multicenter, unblinded, open-label audit, 39 patients (with a total of 43 pains) received a short duration (3 to 5 days) ketamine infusion. The initial dose of 100 mg/ 24 hr was escalated if required to 300 mg/24 hr and then to a maximum dose of 500 mg/ 24hr. The overall response rate was 29/43 (67%). Analysis of results according to pain mechanisms showed that 15/17 somatic and 14/23 neuropathic pains responded. In 5 patients who appeared to respond, it is possible that another concurrent intervention may have contributed in whole or part for the pain relief observed. After cessation of ketamine, 24/29 maintained good pain control, with a maximum documented duration of eight weeks. However, 5 of the initial 29 responders experienced a recurrence of pain within 24 hours, and ketamine was recommenced. Of these, 2 underwent another intervention for pain control while 3 continued on ketamine until their deaths between two and four weeks later. Twelve patients reported adverse psychomimetic effects, with the incidence rising with increasing dose. Four of these were non-responders and the ketamine was stopped. Eight were responders, and in 3 the adverse effects were rendered acceptable with dose reduction; the other 5 rejected a dose reduction. The results reported suggest the need for further investigation of the place of ketamine in cancer pain management.
2001-10

Rights

Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).

Type

Journal Article

Citation List Month

Backlog

Pages

834-42

Issue

4

Volume

22

Citation

Jackson K; Ashby M; Martin P; PallMed Dip; Pisasale M; Brumley D; Hayes B, ““Burst” Ketamine for Refractory Cancer Pain: An Open-Label Audit of 39 Patients Kate Jackson, MB BS, DTM&H, FRCA, FAChPM, Michael Ashby, MB,” Pediatric Palliative Care Library, accessed August 17, 2018, https://pedpalascnetlibrary.omeka.net/items/show/11600.

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