Pain
August 1, 1999
Roger Schmid, Alan N. Sandler, Joel Katz
547 citations
Ketamine, an anesthetic and short-acting analgesic used for nearly 30 years, has renewed clinical interest as an NMDA receptor antagonist for pain management. This review of randomized, double-blind, controlled trials from 1966 to 1998 examined low-dose ketamine for acute postoperative pain, defined as a bolus less than 2 mg/kg intramuscularly or less than 1 mg/kg intravenously or epidurally, or a continuous intravenous rate of 20 µg/kg per minute or less. The evidence suggests low-dose ketamine may improve postoperative pain management and reduce opioid-related adverse effects when used as an adjunct to local anesthetics, opioids, or other analgesics. Further research is needed on dosing, optimal routes, S(+)-ketamine, long-term outcomes, stability, spinal toxicity, and cognitive effects.
Canadian Journal of Pain
November 8, 2024
Jiwon Lee, Kaylyssa Philip, Hance Clarke et al.
3 citations
A proposed clinical trial design for psilocybin as a treatment for neuropathic pain, called the PEACE-PAIN trial, is supported by patient survey responses but could be improved by adding detailed discussions of the existing evidence on efficacy, safety, tolerability, and management of adverse effects. The finding that individuals with prior psychedelic use are interested in participating has important implications for the trial's inclusion and exclusion criteria.
JMIR research protocols
April 17, 2024
Akash Goel, Bhavya Kapoor, Hillary Chan et al.
2 citations
Chronic pain affects about 8 million Canadians (20%) and costs the healthcare system over US $60 billion yearly. This paper describes the planned protocol for a pilot randomized controlled trial testing three treatments: intravenous ketamine alone, cognitive behavioral therapy with mindfulness meditation (CBT/MM), or a combination of both. The primary goal is to assess feasibility—recruitment, consent, withdrawal, adherence, missing data, and adverse events—in 30 participants over 20 weeks. Secondary outcomes include changes in pain intensity and pain interference at week 20. Recruitment had not started as of November 2023; the study is expected to complete by December 2025. Results will inform a larger trial.
Journal of Pain Research
June 1, 2022
Sandra J Drozdz, Akash Goel, Matthew W Mcgarr et al.
2 citations
Ketamine-assisted psychotherapy (KAP) can, in specific circumstances, initiate and prolong clinically significant reductions in pain, anxiety, and depressive symptoms, while encouraging rapport and treatment engagement, and promoting abstinence in patients addicted to other substances. A systematic review of seventeen articles including 603 participants found that combining ketamine with psychotherapy, provided before, during, and after ketamine sessions, can maximize and prolong benefits despite much variance in how KAP is applied. Additional large-scale randomized controlled trials are warranted to understand better the mutually influential relationships between psychotherapy and ketamine in optimizing responsiveness and sustaining long-term benefits in patients with chronic pain.
Journal of pain research
January 1, 2025
Darren K Cheng, Robert Simpson, Rahim Moineddin et al.
A virtual Sahaj Samadhi Meditation program did not significantly outperform an active control (Health Enhancement Program) in reducing depressive symptoms among people with chronic pain and moderate depression. Within the meditation group, depressive symptoms decreased by an average of 3.97 points on the PHQ-9 at 12 weeks and 4.96 points at 24 weeks, both exceeding the minimal clinically important difference, while the control group showed no significant change. The trial enrolled 108 participants, with 89 randomized. The findings suggest potential benefits of the meditation program, but larger trials under non-pandemic conditions are needed to confirm effectiveness.