Ketamine in Chronic Pain: A Review

Area of Science:

• Anesthesiology
• Pain Medicine
• Pharmacology

Background:

• Ketamine is utilized for various pain syndromes, especially neuropathic pain.
• Sub-anesthetic ketamine doses provide potent analgesia via N-methyl-D-aspartate receptor inhibition and descending pathway enhancement.
• Short-term perioperative analgesic effects and reduced chronic pain/opioid use are documented.

Purpose of the Study:

• To review the analgesic and anti-depressive effects of ketamine in pain management.
• To discuss the limitations and side effects of ketamine therapy.
• To highlight the need for further research on long-term safety and risk-benefit.

Main Methods:

• Literature review of ketamine's use in pain syndromes.
• Analysis of ketamine's mechanism of action (N-methyl-D-aspartate receptor inhibition).
• Evaluation of clinical evidence for short-term and long-term benefits and side effects.

Main Results:

• Ketamine demonstrates short-term analgesic efficacy, reducing postoperative pain and opioid consumption.
• Evidence for long-term benefits exists but requires more extensive clinical study.
• Psychomimetic side effects are significant; co-administration with other agents can improve tolerability.

Conclusions:

• Ketamine is a valuable option for neuropathic pain and may offer anti-depressive benefits.
• Long-term safety and a comprehensive risk-benefit analysis require further investigation.
• Optimizing ketamine's clinical application may involve co-administration strategies.