Niesters Marieke, Dahan Albert, van Kleef Maarten
Leids Universitair Medisch Centrum, afd. Anesthesiologie, Leiden.
Ned Tijdschr Geneeskd. 2016;160:D58.
Intravenous ketamine treatment is frequently used for the management of chronic pain, especially in those patients who do not benefit from other therapies. In this commentary we discuss the efficacy of ketamine for relief of chronic pain and ketamine's safety profile. A review of the literature indicates that only a few studies show that intravenous ketamine has analgesic effects that persist beyond the infusion period, an effect that occurs in about two-thirds of patients. Ketamine has multiple safety issues, ranging from psychotomimetic and schizotypal symptoms, sympathetic stimulation, tachycardia and hypertension, and damage to the liver and the urogenital tract. Damage to the urogenital tract seems to be restricted to individuals who chronically abuse ketamine. We indicate the need for large randomized trials in which ketamine is compared with an 'active' placebo.
静脉注射氯胺酮治疗常用于慢性疼痛的管理，尤其是在那些无法从其他疗法中获益的患者中。在本评论中，我们讨论氯胺酮缓解慢性疼痛的疗效及其安全性。文献综述表明，只有少数研究显示静脉注射氯胺酮具有超过输注期的镇痛作用，约三分之二的患者会出现这种效应。氯胺酮存在多种安全问题，包括拟精神病和分裂样症状、交感神经刺激、心动过速和高血压，以及对肝脏和泌尿生殖道的损害。泌尿生殖道损伤似乎仅限于长期滥用氯胺酮的个体。我们指出需要进行大型随机试验，将氯胺酮与“活性”安慰剂进行比较。
