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[氯胺酮与慢性疼痛:关于其疗效及不良事件的叙述性综述]

[Ketamine and chronic pain: A narrative review of its efficacy and its adverse events].

作者信息

Pickering Gisèle, Morel Véronique, Micallef Joelle

机构信息

Centre de pharmacologie clinique, CHU Clermont-Ferrand, 63003 Clermont-Ferrand, France; Inserm, CIC 1405, Neurodol 1107, 63003 Clermont-Ferrand, France; Laboratoire de pharmacologie, faculté de médecine, Clermont université, 63001 Clermont-Ferrand, France.

Centre de pharmacologie clinique, CHU Clermont-Ferrand, 63003 Clermont-Ferrand, France; Inserm, CIC 1405, Neurodol 1107, 63003 Clermont-Ferrand, France.

出版信息

Therapie. 2018 Dec;73(6):529-539. doi: 10.1016/j.therap.2018.06.001. Epub 2018 Jun 19.

Abstract

Ketamine is frequently used in the management of refractory chronic pain. To date, the level of proof in the literature on ketamine in this type of indication is generally poor and physicians have no consensus or recommendation to support their practice. This narrative review is an update on literature data assessing the efficacy and safety of ketamine in chronic pain. The electronic search of the Medline, PubMed, Google Scholar and Cochrane databases identified a total of 61 articles including randomized and non-randomized trials and 14 international reviews. In view of these data, it is difficult to conclude on the effectiveness of ketamine in this type of indication and on its safety due to the heterogeneity of practice in terms of doses, routes, duration and frequency of administration and especially a lack of clinical trials with a high level of evidence.

摘要

氯胺酮常用于难治性慢性疼痛的治疗。迄今为止,关于氯胺酮在这类适应症方面的文献证据水平普遍较低,医生们对于如何开展实践尚未达成共识或得到相关推荐。这篇叙述性综述是对评估氯胺酮在慢性疼痛中疗效和安全性的文献数据的更新。通过对Medline、PubMed、谷歌学术和Cochrane数据库进行电子检索,共识别出61篇文章,包括随机和非随机试验以及14篇国际综述。鉴于这些数据,由于在剂量、给药途径、持续时间和频率方面的实践存在异质性,尤其是缺乏具有高水平证据的临床试验,因此很难就氯胺酮在这类适应症中的有效性及其安全性得出结论。

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