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The Efficacy of Ketamine for Acute and Chronic Pain in Patients With Cancer: A Systematic Review of Randomized Controlled Trials Publisher



Azari L1 ; Hemati H2 ; Tavasolian R3 ; Shahdab S2 ; Tomlinson SM1 ; Babilonia MB4, 5, 6 ; Huang J7 ; Tometich DB8 ; Turner K6, 8 ; Anaraki KS9 ; Jim HSL6, 8 ; Tabriz AA6, 8
Authors
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Authors Affiliations
  1. 1. Morsani College of Medicine, University of South Florida, Tampa, 33602, FL, United States
  2. 2. College of Pharmacy, Tehran University of Medical Sciences, Tehran, 1416753955, Iran
  3. 3. Department of Clinical Science and Nutrition, University of Chester, Chester, CH1 4BJ, United Kingdom
  4. 4. Supportive Care Medicine Department, Behavioral Medicine Services, Moffitt Cancer Center, Tampa, 33612, FL, United States
  5. 5. Department of Psychiatry and Behavioral Medicine, University of South Florida Morsani College of Medicine, Tampa, 33602, FL, United States
  6. 6. Department of Oncological Sciences, University of South Florida Morsani College of Medicine, Tampa, 33602, FL, United States
  7. 7. Department of Anesthesiology, Moffitt Cancer Center, Tampa, 33612, FL, United States
  8. 8. Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, 33612, FL, United States
  9. 9. Department of Internal Medicine, University of Maryland Capital Region, Largo, 20774, MD, United States

Source: Healthcare (Switzerland) Published:2024


Abstract

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. © 2024 by the authors.
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