Ketamine Infusion for Complex Regional Pain Syndrome Treatment: A Narrative Review.

Complex Regional Pain Syndrome (CRPS) is a chronic pain condition where pain is much greater than expected from the initial injury and lasts a long time. Many standard treatments have been unsatisfactory. Ketamine, a drug that blocks NMDA receptors and is normally used for anesthesia and pain relief, shows promise for CRPS patients who do not respond to usual therapies. Multiple studies report significant improvements in pain severity, limb mobility, and other measures after ketamine infusion. Side effects such as nausea, vomiting, headache, or psychotropic symptoms were uncommon and reversible by stopping the drug. More research is needed on optimal dosing and duration, but ketamine appears safe and effective for difficult CRPS cases. This review summarizes current knowledge on ketamine infusions for CRPS to help physicians weigh benefits and risks.

Study at a glance

Abstract

Complex Regional Pain Syndrome (CRPS) is a neuropathic pain disorder characterized by pain disproportionate to the inciting event that is constant for an extended duration. Numerous treatment options for this condition have been explored with unsatisfactory results in many cases. Ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist typically used as an anesthetic and analgesic, presents a promising potential treatment for CRPS in patients who fail to respond to traditional therapies. Numerous studies report significant improvement in the degree of pain, mobility of extremities, and other parameters after ketamine infusion in patients with CRPS. Although adverse effects were not reported often, some subjects experienced nausea, vomiting, headache or psychotropic or psychomimetic symptoms which could be mitigated with cessation of the drug. Although more research is needed to determine optimal dosing and duration, ketamine seems to be a safe and effective treatment for refractory cases of CRPS. The present investigation summarizes existing knowledge and research surrounding ketamine infusions for CRPS to provide a well-rounded depiction of advantages and disadvantages for physicians who may be considering it for patients with this challenging and complex condition.