Żyluk Andrzej, Pastuszka Joanna
Department of General and Hand Surgery, Pomeranian Medical University, Szczecin, Poland.
Department of Anaesthesiology and Intensive Therapy, Pomeranian Medical University, Szczecin, Poland.
Pol Orthop Traumatol. 2014 Apr 7;79:37-40.
Abstract Chronic algodystrophy is difficult to treat, because the disease in this stage is usually resistant to many therapies. It particularly concerns conditions with predominant severe, intractable pain and disability of the involved extremity. In these, the severest cases, searching for effective pain control therapy is extremely important. Intravenous ketamine infusions constitute a promising therapy, which appeared recently. Ketamine possesses properties of blocking central sensitization and development of neuropathic pain through its effect on NMDA receptor, a critical factor in this process. The article presents problem of chronic, refractory algodystrophy, mechanism of ketamine action in pain control, literature review on treatment outcomes and authors' own experience in this field. Ketamine seems to be a useful option for pain control in patients with refractory algodystrophy.
摘要 慢性痛性营养不良症难以治疗，因为该阶段的疾病通常对多种治疗方法具有抗性。它尤其涉及以受累肢体严重、顽固性疼痛和功能障碍为主的病症。在这些最严重的病例中，寻找有效的疼痛控制疗法极为重要。静脉输注氯胺酮是一种最近出现的、很有前景的治疗方法。氯胺酮通过作用于N-甲基-D-天冬氨酸（NMDA）受体（此过程中的关键因素），具有阻断中枢敏化和神经性疼痛发展的特性。本文介绍了慢性难治性痛性营养不良症的问题、氯胺酮在疼痛控制中的作用机制、关于治疗结果的文献综述以及作者本人在该领域的经验。氯胺酮似乎是难治性痛性营养不良症患者疼痛控制的一种有用选择。
