Ketamine for pain in adults and children with cancer: a systematic review and synthesis of the literature

Title

Ketamine for pain in adults and children with cancer: a systematic review and synthesis of the literature

Creator

Bredlau AL; Thakur R; Korones DN; Dworkin RH

Identifier

Publisher

Pain Medicine (malden, Mass.)

Date

2013

Subject

Child; Humans; Neoplasms; Pain; Pain Management; Adult; Analgesics; Clinical Trials as Topic; Ketamine; Intractable

Description

OBJECTIVE: Chronic cancer pain is often refractory and difficult to treat. Ketamine is a medication with evidence of efficacy in the treatment of chronic pain. DESIGN: This article presents a synthesis of the data on ketamine for refractory cancer pain in adults and children. RESULTS: There are five randomized, double-blind, controlled trials of ketamine use in cancer pain that demonstrate improvement in pain for some patients. There are six prospective, uncontrolled trials in cancer pain that also demonstrate improvement in pain scores for some patients. There are no randomized, controlled trials in children with cancer pain, although there are a few studies reflecting improved pain control with ketamine for children with cancer pain. Adverse events for adults on ketamine are most commonly somnolence, feelings of insobriety, nausea/vomiting, hallucinations, depersonalization/derealization, and drowsiness. However, when ketamine is combined with benzodiazepines, feelings of insobriety, hallucinations, and depersonalization/derealization are not reported. Children on ketamine have had few reported adverse effects, which include sedation, anorexia, urinary retention, and myoclonic movements. Recommended ketamine infusion dosages are from 0.05 to 0.5 mg/kg/h (intravenous or subcutaneous). Recommended oral dosages of ketamine are 0.2-0.5 mg/kg/dose two to three times daily with a maximum of 50 mg/dose three times daily. CONCLUSIONS: Despite limitations in the breadth and depth of data available, there is evidence that ketamine may be a viable option for treatment-refractory cancer pain.
2013-10

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

1505-1517

Issue

10

Volume

14

Citation

Bredlau AL; Thakur R; Korones DN; Dworkin RH, “Ketamine for pain in adults and children with cancer: a systematic review and synthesis of the literature,” Pediatric Palliative Care Library, accessed July 28, 2021, https://pedpalascnetlibrary.omeka.net/items/show/14703.

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