Bodnar Michael S, Barber Sierra, Jim Heather S L, Huang Jeffery
University of South Florida Morsani College of Medicine, Tampa, FL 34433, USA.
Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 34433, USA.
J Anesth Transl Med. 2024 Dec;3(4):155-165. doi: 10.1016/j.jatmed.2024.10.005. Epub 2024 Nov 29.
Depression and pain are common comorbidities in cancer patients, and ketamine, a dissociative anesthetic, has shown potential in managing both. This review summarizes current literature on ketamine and its enantiomer, esketamine, in managing depression and pain in the oncologic population. Studies indicate that sub-anesthetic doses of intravenous ketamine and esketamine can alleviate postoperative depressive symptoms in cancer patients with a tolerable safety profile. Research into non-intravenous routes for depression management in the oncologic population remains limited. Ketamine has also proven effective in managing acute postoperative pain, particularly through intravenous administration. While alternative administration routes, such as local infiltration and intramuscular methods, show mixed results, they may provide viable options for patients averse to intravenous (IV). However, the effectiveness of ketamine for chronic cancer pain remains inconsistent. Overall, ketamine offers a promising approach for managing depression and pain in oncologic patients.
抑郁症和疼痛是癌症患者常见的共病，而氯胺酮（一种解离性麻醉剂）在治疗这两种病症方面已显示出潜力。本综述总结了关于氯胺酮及其对映体艾氯胺酮在肿瘤患者中治疗抑郁症和疼痛的当前文献。研究表明，亚麻醉剂量的静脉注射氯胺酮和艾氯胺酮可以缓解癌症患者术后的抑郁症状，且安全性可耐受。针对肿瘤患者抑郁症管理的非静脉途径的研究仍然有限。氯胺酮在治疗急性术后疼痛方面也已被证明有效，特别是通过静脉给药。虽然替代给药途径，如局部浸润和肌肉注射方法，结果不一，但它们可能为不愿接受静脉注射（IV）的患者提供可行的选择。然而，氯胺酮对慢性癌症疼痛的有效性仍然不一致。总体而言，氯胺酮为管理肿瘤患者的抑郁症和疼痛提供了一种有前景的方法。
