Jackson Kate, Ashby Michael, Howell Deb, Petersen Jennifer, Brumley David, Good Phillip, Pisasale Maria, Wein Simon, Woodruff Roger
Supportive and Palliative Care Unit, Southern Health and Monash University, and McCulloch House PCU, Monash Medical Centre, Locked Bag 29, Clayton South, Victoria 3169, Australia.
J Palliat Care. 2010 Autumn;26(3):176-83.
This multi-centre study of adjuvant "burst" ketamine in palliative care in-patients documents its effectiveness, duration of pain relief, and adverse effects (AE) profile. Patients received a three-to-five day continuous subcutaneous infusion (CSCI) of ketamine escalated from 100 to 300 to 500 mg/24 hours if required. When the effective or maximum tolerated dose was attained, the infusion was continued for three days and each patient assessed as a responder or non-responder using strict criteria. The response rate was 22/44 (50 percent), with 4 (9 percent) becoming pain-free. Pain relief lasting two or more weeks was documented in 50 percent of responders. AEs were documented daily using the National Cancer Institute (NCI) Common Toxicity Criteria 0-4 scales. There were 11 grade 3 and 4 neurological AEs. However, no responders elected to cease treatment early due to neurological AEs. We concluded that this protocol in the controlled environment of an in-patient PC unit is relatively safe and simple with reasonable effectiveness.
这项关于姑息治疗住院患者辅助“冲击式”氯胺酮治疗的多中心研究记录了其有效性、疼痛缓解持续时间和不良反应（AE）情况。患者接受为期三至五天的氯胺酮持续皮下输注（CSCI），根据需要，剂量从100毫克/24小时逐步增至300毫克/24小时，再到500毫克/24小时。当达到有效剂量或最大耐受剂量时，输注持续三天，并使用严格标准将每位患者评估为有反应者或无反应者。反应率为22/44（50%），其中4例（9%）疼痛消失。50%的有反应者疼痛缓解持续两周或更长时间。每天使用美国国立癌症研究所（NCI）常见毒性标准0 - 4级量表记录不良反应。有11例3级和4级神经不良反应。然而，没有有反应者因神经不良反应而选择提前停止治疗。我们得出结论，在住院姑息治疗病房的可控环境中，该方案相对安全、简单，且有效性合理。
