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疼痛管理のための低用量経口ケタミン:臨床医のためのプライマー
Jason H Phan1, Michael A Smith1,2
1Department of Pharmacy Services, University of Michigan Health, Ann Arbor, MI, USA.
The Annals of pharmacotherapy
|February 19, 2026
まとめ
低用量経口ケタミン剤は,痛みの管理のための実用的な代替案を提供し,痛みの軽減とオピオイド使用の有効性を示しています. 一般的によく耐えるものの,最適な用量と長期のリスクは,広範な臨床採用のためにさらなる調査を必要とします.
科学分野:
- 薬理学 薬理学とは
- 疼痛管理 疼痛管理
- クリニカル・セラピエティクス
背景:
- オピオイド危機のため,オピオイドを節約する鎮痛剤は極めて重要です.
- ケタミンは,N-メチル-D-アスパルテート受容体アンタゴニストであり,鎮痛作用を示しています.
- 口服ケタミンは,疼痛管理のための便利な配方を提供します.
研究 の 目的:
- 低用量経口ケタミンによる鎮痛に対する証拠を批判的に評価する.
- 実践における経口ケタミン剤の使用に関する臨床的勧告を提供すること.
- 痛みに対する経口ケタミンに関する臨床医の問い合わせに対応するために.
主な方法:
- キーワードを使用したPubMed (2010-2025) の文献検索: "投与,経口", "投与,亜言語", "ケタミン", "痛み".
- 経口または言語下ケタミンによる鎮痛剤に焦点を当てたすべての研究および症例報告を掲載します.
主要な成果:
- 口服ケタミン (25-300 mg/日) はよく耐受され,痛みのスコアを低下させ,生活の質を向上させ,オピオイドの必要性を減少させた.
- 6 mg/kgを超える用量は,副作用の増加と関連していました.
- 最適な親腸から口服への投与量変換は不明ですが,毎日の注入量から75%の減少は,いくつかのケースで鎮痛を維持しました.
結論:
- 低用量経口ケタミン剤は,急性および慢性疼痛に対する証拠が増えているあまり使われていない鎮痛剤です.
- 耐火性疼痛患者,マルチモダル鎮痛を必要とする患者,またはオピオイドを多く使用する患者に利益をもたらす可能性があります.
- 短期的には一般的に安全ですが,経口ケタミン剤の長期的なリスクは不明です.
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