The Efficacy of Ketamine for Acute and Chronic Pain in Patients with Cancer: A Systematic Review of Randomized Controlled Trials.
Healthcare (Basel, Switzerland) – August 06, 2024
Source: PubMed
Summary
Ketamine shows promising results in managing severe cancer pain when traditional treatments fall short. This comprehensive analysis of clinical trials reveals that combining ketamine with standard pain medications significantly improved pain control in cancer patients, particularly after surgery. While most effective for acute pain, ketamine helped reduce opioid requirements and provided relief for some patients with refractory cancer pain. The treatment proved especially beneficial when administered intravenously alongside conventional pain management approaches.
Abstract
Managing cancer-related pain poses significant challenges, prompting research into alternative approaches such as ketamine. This systematic review aims to analyze and summarize the impact of ketamine as an adjuvant to opioid therapy for cancer-related pain. We conducted a literature review in MEDLINE, EMBASE, and Scopus from 1 January 1982 to 20 October 2023. Abstracts were screened against inclusion criteria, and eligible studies underwent a full-text review. Data was extracted from the included studies, and a framework analysis approach summarized the evidence regarding ketamine's use in patients with cancer. A total of 21 randomized clinical trials were included, and the quality of all the included studies was good or fair. Significant improvements in pain scores and reduced morphine consumption were consistently observed with intravenous ketamine administration for postoperative pain control, particularly when combined with other analgesics such as morphine. Ketamine was less effective when used as an analgesic for chronic pain management, with several studies on neuropathic pain or chemotherapy-induced neuropathy finding minimal significant effect on reduction of pain scores or morphine requirements. The efficacy of ketamine in pain management appears to depend on factors such as dosage, route of administration, and patient population.