Azari Leila, Hemati Homa, Tavasolian Ronia, Shahdab Sareh, Tomlinson Stephanie M, Babilonia Margarita Bobonis, Huang Jeffrey, Tometich Danielle B, Turner Kea, Anaraki Kimia Saleh, Jim Heather S L, Tabriz Amir Alishahi
Morsani College of Medicine, University of South Florida, Tampa, FL 33602, USA.
College of Pharmacy, Tehran University of Medical Sciences, Tehran 1416753955, Iran.
Healthcare (Basel). 2024 Aug 6;12(16):1560. doi: 10.3390/healthcare12161560.
Managing cancer-related pain poses significant challenges, prompting research into alternative approaches such as ketamine. This systematic review aims to analyze and summarize the impact of ketamine as an adjuvant to opioid therapy for cancer-related pain. We conducted a literature review in MEDLINE, EMBASE, and Scopus from 1 January 1982 to 20 October 2023. Abstracts were screened against inclusion criteria, and eligible studies underwent a full-text review. Data was extracted from the included studies, and a framework analysis approach summarized the evidence regarding ketamine's use in patients with cancer. A total of 21 randomized clinical trials were included, and the quality of all the included studies was good or fair. Significant improvements in pain scores and reduced morphine consumption were consistently observed with intravenous ketamine administration for postoperative pain control, particularly when combined with other analgesics such as morphine. Ketamine was less effective when used as an analgesic for chronic pain management, with several studies on neuropathic pain or chemotherapy-induced neuropathy finding minimal significant effect on reduction of pain scores or morphine requirements. The efficacy of ketamine in pain management appears to depend on factors such as dosage, route of administration, and patient population.
管理癌症相关疼痛面临重大挑战，这促使人们对诸如氯胺酮等替代方法进行研究。本系统评价旨在分析和总结氯胺酮作为阿片类药物治疗癌症相关疼痛辅助药物的影响。我们在1982年1月1日至2023年10月20日期间对MEDLINE、EMBASE和Scopus数据库进行了文献综述。根据纳入标准筛选摘要，符合条件的研究进行全文审查。从纳入的研究中提取数据，并采用框架分析方法总结有关氯胺酮在癌症患者中使用的证据。共纳入21项随机临床试验，所有纳入研究的质量为良好或中等。静脉注射氯胺酮用于术后疼痛控制时，疼痛评分有显著改善，吗啡消耗量减少，尤其是与吗啡等其他镇痛药联合使用时。氯胺酮用作慢性疼痛管理的镇痛药时效果较差，多项关于神经性疼痛或化疗引起的神经病变的研究发现，对降低疼痛评分或吗啡需求量的显著效果极小。氯胺酮在疼痛管理中的疗效似乎取决于剂量、给药途径和患者群体等因素。
