Monash University (P.P.), Faculty of Medicine Nursing and Health Sciences, Clayton, Victoria, Australia; Supportive and Palliative Care Department (P.P.), Monash Health, Clayton, Victoria, Australia.
Regional Centre of Excellence in Palliative Care (R.F.B.), Haukeland University Hospital, Bergen, Norway.
J Pain Symptom Manage. 2024 Aug;68(2):e146-e151. doi: 10.1016/j.jpainsymman.2024.04.026. Epub 2024 May 8.
In the cancer pain setting, ketamine has been typically employed as a co-analgesic for opioid refractory and neuropathic pain. One controversial topic is whether subanesthetic ketamine be considered when managing opioid refractory cancer pain. In this "Controversies in Palliative Care" article, three clinicians independently answer this question. Specifically, each clinician provides a synopsis of the key studies that inform their thought processes, share practical advice on their clinical approach, and highlight the opportunities for future research. Three independent clinicians reported a divergence of opinion regarding the usefulness of subanesthetic ketamine for managing opioid refractory cancer pain. All investigators acknowledged the lack of high-quality trials. All agreed on the need for adequately powered trials, the development of standardized methodology, and the exploration of any patient sub-populations that may benefit from ketamine for cancer related pain.
在癌症疼痛治疗中，氯胺酮通常被用作治疗阿片类药物难治性和神经性疼痛的辅助药物。一个有争议的话题是，在治疗阿片类药物难治性癌症疼痛时是否应考虑使用亚麻醉剂量的氯胺酮。在这篇“姑息治疗的争议”文章中，三位临床医生独立回答了这个问题。具体来说，每位临床医生都提供了对其思维过程有重要影响的关键研究的概要，分享了他们临床方法的实用建议，并强调了未来研究的机会。三位独立的临床医生报告说，他们对亚麻醉剂量氯胺酮治疗阿片类药物难治性癌症疼痛的有效性存在意见分歧。所有研究人员都承认缺乏高质量的试验。所有人都同意需要进行足够大样本量的试验，制定标准化的方法，并探索任何可能从氯胺酮治疗癌症相关疼痛中受益的患者亚群。
