Kong P E Lee, Snijdelaar D G, Crul B J P
Universitair Medisch Centrum St Radbound, afd. Anesthesiologie/Pijncentrum, Postbus 9101, 6500 HB Nijmegen.
Ned Tijdschr Geneeskd. 2002 Dec 28;146(52):2556-8.
In three patients, a 52-year-old woman with skeletal metastases from bladder carcinoma, a 54-year-old man with metastasised thyroid carcinoma and a 40-year-old man with a non-Hodgkin lymphoma, neuropathic pain developed that could not be alleviated adequately by patient-controlled opioid administration. It is known that ketamine, a N-methyl-D-aspartate (NMDA) receptor antagonist, can improve opioid-induced analgesia. Pending invasive therapy, the three patients were given a continuous low dose of parenteral ketamine (2-5 micrograms/kg/min). The pain in the first two patients responded so well to ketamine that they decided to waive the invasive pain treatment and to continue the ketamine infusion at home until death. In the third patient, the addition of ketamine resulted in an adequate level of analgesia during the waiting period for invasive treatment with an intrathecal catheter.
在三名患者中，一名52岁患有膀胱癌骨转移的女性、一名54岁患有转移性甲状腺癌的男性和一名40岁患有非霍奇金淋巴瘤的男性，出现了经患者自控给予阿片类药物无法充分缓解的神经性疼痛。已知N-甲基-D-天冬氨酸（NMDA）受体拮抗剂氯胺酮可改善阿片类药物诱导的镇痛效果。在等待侵入性治疗期间，这三名患者接受了持续低剂量的肠外氯胺酮（2 - 5微克/千克/分钟）治疗。前两名患者的疼痛对氯胺酮反应良好，以至于他们决定放弃侵入性疼痛治疗，并在家中继续输注氯胺酮直至死亡。在第三名患者中，添加氯胺酮后在等待鞘内导管侵入性治疗的期间达到了足够的镇痛水平。
