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氯胺酮用于治疗慢性疼痛:一项全面综述。

Ketamine for the Treatment of Chronic Pain: A Comprehensive Review.

作者信息

Israel Jacob E, St Pierre Samantha, Ellis Emily, Hanukaai Josephine S, Noor Nazir, Varrassi Giustino, Wells Markus, Kaye Alan D

机构信息

Georgetown University.

Louisiana State University Health Shreveport.

出版信息

Health Psychol Res. 2021 Jul 10;9(1):25535. doi: 10.52965/001c.25535. eCollection 2021.

Abstract

BACKGROUND

Chronic pain significantly worsens the quality of life. Unlike neuropathic, musculoskeletal, postoperative pain, and cancer pain, chronic primary pain cannot be explained by an underlying disease or condition, making its treatment arduous.

OBJECTIVES

This manuscript intends to provide a comprehensive review of the use of ketamine as a treatment option for specific chronic pain conditions.

STUDY DESIGN

A review article.

SETTING

A review of the literature.

METHODS

A search was done on PubMed for relevant articles.

RESULTS

A comprehensive review of the current understanding of chronic pain and the treatment of specific chronic pain conditions with ketamine.

LIMITATIONS

Literature is scarce regarding the use of ketamine for the treatment of chronic pain.

CONCLUSION

First-line treatment for many chronic pain conditions includes NSAIDs, antidepressants, anticonvulsants, and opioids. However, these treatment methods are unsuccessful in a subset of patients. Ketamine has been explored in randomized controlled trials (RCTs) as an alternative treatment option, and it has been demonstrated to improve pain symptoms, patient satisfaction, and quality of life. Conditions highlighted in this review include neuropathic pain, fibromyalgia, complex regional pain syndrome (CRPS), phantom limb pain (PLP), cancer pain, and post-thoracotomy pain syndrome. This review will discuss conditions, such as neuropathic pain, fibromyalgia, complex regional pain syndrome, and more and ketamine's efficacy and its supplementary benefits in the chronic pain patient population. As the opioid crisis in the United States continues to persist, this review aims to understand better multimodal analgesia, which can improve how chronic pain is managed.

摘要

背景

慢性疼痛会显著降低生活质量。与神经性疼痛、肌肉骨骼疼痛、术后疼痛和癌痛不同,慢性原发性疼痛无法用潜在疾病或状况来解释,这使得其治疗十分艰巨。

目的

本文旨在全面综述氯胺酮作为特定慢性疼痛病症治疗选择的应用情况。

研究设计

一篇综述文章。

研究背景

对文献的综述。

方法

在PubMed上搜索相关文章。

结果

对慢性疼痛的当前认识以及氯胺酮治疗特定慢性疼痛病症的情况进行了全面综述。

局限性

关于氯胺酮用于治疗慢性疼痛的文献较少。

结论

许多慢性疼痛病症的一线治疗包括非甾体抗炎药、抗抑郁药、抗惊厥药和阿片类药物。然而,这些治疗方法在一部分患者中并不成功。氯胺酮已在随机对照试验(RCT)中作为替代治疗选择进行了探索,并且已证明它能改善疼痛症状、患者满意度和生活质量。本综述重点关注的病症包括神经性疼痛、纤维肌痛、复杂性区域疼痛综合征(CRPS)、幻肢痛(PLP)、癌痛和开胸术后疼痛综合征。本综述将讨论诸如神经性疼痛、纤维肌痛、复杂性区域疼痛综合征等病症,以及氯胺酮在慢性疼痛患者群体中的疗效及其附加益处。鉴于美国的阿片类药物危机持续存在,本综述旨在更好地理解多模式镇痛,这有助于改善慢性疼痛的管理方式。

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