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氯胺酮输注治疗复杂性区域疼痛综合征:一项叙述性综述。

Ketamine Infusion for Complex Regional Pain Syndrome Treatment: A Narrative Review.

作者信息

Kaye Alan D, Tynes Brynne E, Johnson Coplen D, Strong Bryan C, Abbott Brennan M, Vučenović Jelena, Viswanath Omar, Fox Charles J, Ahmadzadeh Shahab, Amarasinghe Sam N, Kataria Saurabh, Shekoohi Sahar

机构信息

Department of Anesthesiology/Department of Pharmacology, Toxicology, and Neurosciences, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, 71103, USA.

Louisiana State University Health Sciences Center School of Medicine, Shreveport, LA, USA.

出版信息

Curr Pain Headache Rep. 2025 Jan 14;29(1):26. doi: 10.1007/s11916-025-01360-9.

Abstract

PURPOSE OF REVIEW

Complex Regional Pain Syndrome (CRPS) is a neuropathic pain disorder characterized by pain disproportionate to the inciting event that is constant for an extended duration. Numerous treatment options for this condition have been explored with unsatisfactory results in many cases. Ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist typically used as an anesthetic and analgesic, presents a promising potential treatment for CRPS in patients who fail to respond to traditional therapies.

RECENT FINDINGS

Numerous studies report significant improvement in the degree of pain, mobility of extremities, and other parameters after ketamine infusion in patients with CRPS. Although adverse effects were not reported often, some subjects experienced nausea, vomiting, headache or psychotropic or psychomimetic symptoms which could be mitigated with cessation of the drug. Although more research is needed to determine optimal dosing and duration, ketamine seems to be a safe and effective treatment for refractory cases of CRPS.

CONCLUSION

The present investigation summarizes existing knowledge and research surrounding ketamine infusions for CRPS to provide a well-rounded depiction of advantages and disadvantages for physicians who may be considering it for patients with this challenging and complex condition.

摘要

综述目的

复杂性区域疼痛综合征(CRPS)是一种神经性疼痛疾病,其特征为疼痛程度与诱发事件不成比例,且持续时间较长。针对这种病症已探索了多种治疗方案,但在许多情况下效果并不理想。氯胺酮是一种N-甲基-D-天冬氨酸(NMDA)受体拮抗剂,通常用作麻醉剂和镇痛药,对于对传统疗法无反应的CRPS患者而言,它是一种有前景的潜在治疗方法。

最新发现

大量研究报告称,CRPS患者输注氯胺酮后,疼痛程度、肢体活动能力及其他指标有显著改善。虽然不良反应报告不多,但一些受试者出现了恶心、呕吐、头痛或精神或拟精神症状,停药后这些症状可得到缓解。尽管需要更多研究来确定最佳剂量和疗程,但氯胺酮似乎是治疗难治性CRPS病例的一种安全有效的方法。

结论

本研究总结了关于CRPS氯胺酮输注的现有知识和研究,以便为可能考虑将其用于患有这种具有挑战性和复杂性疾病患者的医生全面描述其优缺点。

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