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门诊氯胺酮输注治疗纤维肌痛和慢性疼痛综合征:一例报告

Outpatient Ketamine Infusions for the Treatment of Fibromyalgia and Chronic Pain Syndrome: A Case Report.

作者信息

Sharma Sonakshi, Gupta Ruchir

机构信息

Pain Management, Mountain View Headache and Spine Institute, Phoenix, USA.

出版信息

Cureus. 2023 Sep 8;15(9):e44909. doi: 10.7759/cureus.44909. eCollection 2023 Sep.

Abstract

Intravenous (IV) ketamine has demonstrable efficacy for chronic pain management. Its use in an outpatient setting has provided relief from myriad pain syndromes and additionally may reduce dependence on opioids. Nevertheless, its long-term ability to provide these benefits is understudied. Here, we present the case of a 68-year-old female who presented to our clinic with persistent fibromyalgia, accompanied by other pain symptoms that had been recalcitrant to traditional pain management therapy including nerve blocks, ablations, spinal cord stimulation, and morphine medication. We administered seven increasing IV ketamine doses over two weeks. The patient reported significant, widespread pain relief. The patient continued to receive IV ketamine twice weekly for over a year and remains on this schedule. Pain relief has persisted under this regimen, along with a demonstrable improvement in quality of life, a reduced use of morphine, and the cessation of anti-depressant medication. This case indicates that long-term ketamine infusions show promise for chronic pain management and that more longitudinal studies on this treatment are warranted.

摘要

静脉注射氯胺酮在慢性疼痛管理方面具有显著疗效。其在门诊环境中的使用已为多种疼痛综合征带来缓解,此外还可能减少对阿片类药物的依赖。然而,其提供这些益处的长期能力尚未得到充分研究。在此,我们报告一例68岁女性病例,该患者因持续性纤维肌痛前来我们诊所就诊,伴有其他疼痛症状,这些症状对包括神经阻滞、消融、脊髓刺激和吗啡药物在内的传统疼痛管理治疗均无反应。我们在两周内分七次递增静脉注射氯胺酮剂量。患者报告疼痛得到显著且广泛的缓解。该患者继续每周接受两次静脉注射氯胺酮治疗,持续了一年多,目前仍按此方案治疗。在该治疗方案下,疼痛缓解持续存在,同时生活质量有明显改善,吗啡使用量减少,抗抑郁药物停用。该病例表明,长期氯胺酮输注在慢性疼痛管理方面显示出前景,有必要对这种治疗方法进行更多的纵向研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9951/10560537/29b5d2d58db5/cureus-0015-00000044909-i01.jpg

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