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Titolo:
Analgesic effect of intravenous ketamine in cancer patients on morphine therapy: A randomized, controlled, double-blind, crossover, double-dose study
Autore:
Mercadante, S; Arcuri, E; Tirelli, W; Casuccio, A;
Indirizzi:
SAMOT, Pain Relief & Palliat Care Program, I-90143 Palermo, Italy SAMOT Palermo Italy I-90143 Palliat Care Program, I-90143 Palermo, Italy SAMOT, Anesthesia & Intens Care Unit, Pain Relief & Palliat Care Unit, I-90143 Palermo, Italy SAMOT Palermo Italy I-90143 & Palliat Care Unit, I-90143 Palermo, Italy SAMOT, La Maddalena Clin Canc, I-90143 Palermo, Italy SAMOT Palermo Italy I-90143 Maddalena Clin Canc, I-90143 Palermo, Italy Natl Canc Inst Regina Elena, Dept Pain Therapy & Intens Care, Rome, Italy Natl Canc Inst Regina Elena Rome Italy erapy & Intens Care, Rome, Italy Univ Palermo, Dept Hyg & Microbiol, Palermo, Italy Univ Palermo Palermo Italy alermo, Dept Hyg & Microbiol, Palermo, Italy
Titolo Testata:
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT
fascicolo: 4, volume: 20, anno: 2000,
pagine: 246 - 252
SICI:
0885-3924(200010)20:4<246:AEOIKI>2.0.ZU;2-C
Fonte:
ISI
Lingua:
ENG
Soggetto:
NEUROPATHIC PAIN; OPIOID RESPONSIVENESS; TERMINAL CANCER; DEXTROMETHORPHAN; INFUSION;
Keywords:
cancer pain; opioid response; neuropathic pain; ketamine; NMDA-antagonist; adverse effects; randomized controlled epidemiologic study;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
25
Recensione:
Indirizzi per estratti:
Indirizzo: Mercadante, S SAMOT, Pain Relief & Palliat Care Program, Via Liberta 191, I-90143 Palermo, Italy SAMOT Via Liberta 191 Palermo Italy I-90143 Palermo, Italy
Citazione:
S. Mercadante et al., "Analgesic effect of intravenous ketamine in cancer patients on morphine therapy: A randomized, controlled, double-blind, crossover, double-dose study", J PAIN SYMP, 20(4), 2000, pp. 246-252

Abstract

Pain not responsive to morphine is often problematic Animal and clinical studies have suggested that N-methyl-D-aspartate (NMDA) antagonists, such asketamine, may be effective in improving opioid analgesia in difficult painsyndromes, such as neuropathic pain. A slow bolus of subhypnotic doses of ketamine (0.25 mg/kg or 0.50 mg/kg) was given to 10 cancer patients whose pain was unrelieved by morphine in a randomized, double-blind crossover; double-dose study. Pain intensity on a 0 to 10 numerical scale; nausea and vomiting drowsiness, confusion, and dry mouth, using a scale from 0 to 3 (not at all, slight, a lot, awful); Mini-Mental State Examination (MMSE) (0-30);and arterial pressure were recorded before administration of drugs (TO) and after 30 minutes (T30), 60 minutes (T60), 120 minutes (T120), and 180 minutes (T180). Ketamine, but not saline solution, significantly reduced the pain intensity in almost all the patients at both doses. This effect was more relevant in patients treated with higher doses. Hallucinations occurred in 4 patients, patients, and an unpleasant sensation ("empty head") was alsoreported by 2 patients. These episodes reversed after the administration of diazepam 1 mg intravenously. Significant increases in drowsiness were reported in patients treated with ketamine in both groups and were more markedwith ketamine 0.50 mg/kg A significant difference in MMSE wets observed atT30 in patients who received 0.50 mg/kg of ketamine. Ketamine can improve morphine analgesia in difficult pain syndromes, such as neuropathic pain. However, the occurrence of central adverse effects should be taken into account, especially when using higher doses. This observation should be tested in studies of prolonged ketamine administration. (C) U.S. Cancer Pain Relief Committee, 2000.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 19/01/20 alle ore 00:34:41