口腔用氯胺酮治疗慢性疼痛的儿童：一项初步的 1 期研究。
Oral ketamine for children with chronic pain: a pilot phase 1 study.
机构信息
Departments of Pediatrics and Neurosciences, Medical University of South Carolina, Charleston, SC 29425, USA.
出版信息
J Pediatr. 2013 Jul;163(1):194-200.e1. doi: 10.1016/j.jpeds.2012.12.077. Epub 2013 Feb 10.
OBJECTIVE
To assess whether oral ketamine is safe at higher dosages for sedating children and whether it may be an option for the control of chronic pain in children.
STUDY DESIGN
A prospective study was performed on 12 children with chronic pain to identify the maximum tolerated dosage of oral ketamine. Participants were given 14 days of oral ketamine, 3 times daily, at dosages ranging from 0.25-1.5 mg/kg/dose. Participants were assessed for toxicity and for pain severity at baseline and on day 14 of treatment.
RESULTS
Two participants, both treated at 1.5 mg/kg/dose, experienced dose-limiting toxicities (sedation and anorexia). One participant, treated at 1 mg/kg/dose, opted to stop ketamine treatment due to new pain on treatment. Nine participants completed their course of ketamine treatment. Of these 12 children, 5 experienced improvement in their pain scores, 2 with complete resolution of pain, lasting >4 weeks off ketamine treatment.
CONCLUSION
Oral ketamine at dosages of 0.25-1 mg/kg/dose appears to be safe when given for 14 days to children with chronic pain.
目的
评估较高剂量的口服氯胺酮用于镇静儿童是否安全，以及它是否可能成为儿童慢性疼痛控制的一种选择。
研究设计
对 12 名慢性疼痛儿童进行了一项前瞻性研究，以确定口服氯胺酮的最大耐受剂量。参与者接受为期 14 天的每日 3 次口服氯胺酮治疗，剂量范围为 0.25-1.5 mg/kg/剂量。在基线和治疗的第 14 天评估参与者的毒性和疼痛严重程度。
结果
两名参与者（均接受 1.5 mg/kg/剂量）出现剂量限制毒性（镇静和厌食）。一名参与者（接受 1 mg/kg/剂量）因治疗期间出现新的疼痛而选择停止氯胺酮治疗。9 名参与者完成了氯胺酮治疗疗程。在这 12 名儿童中，5 名疼痛评分有所改善，2 名疼痛完全缓解，在停止氯胺酮治疗后持续>4 周。
结论
当给予慢性疼痛儿童 14 天时，口服氯胺酮 0.25-1 mg/kg/剂量似乎是安全的。
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