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Effect of intravenous low‐dose S‐ketamine on pain in patients with Complex Regional Pain Syndrome: A retrospective cohort study.

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Title: Effect of intravenous low‐dose S‐ketamine on pain in patients with Complex Regional Pain Syndrome: A retrospective cohort study.
Authors: Mangnus, Thomas J. P., Dirckx, Maaike, Bharwani, Krishna D., de Vos, Cecile C., Frankema, Sander P. G., Stronks, Dirk L., Huygen, Frank J. P. M.
Source: Pain Practice. Nov2021, Vol. 21 Issue 8, p890-897. 8p. 1 Diagram, 3 Charts, 1 Graph.
Subjects: Statistical significance, Pain, Pain measurement, Retrospective studies, Treatment duration, Mann Whitney U Test, Treatment effectiveness, Ketamine, Descriptive statistics, Complex regional pain syndromes, Intravenous injections, Data analysis software, Data analysis, Longitudinal method, Pain management
Abstract: Objective: The objective of this study was to assess the effectiveness of a low‐dose intravenous S‐ketamine treatment on refractory pain in patients with Complex Regional Pain Syndrome (CRPS). Methods: In this retrospective study, patients with CRPS who received intravenous S‐ketamine from March 2010 to April 2019 were included. According to our inpatient protocol, S‐ketamine dose was increased until pain reduction was achieved or side effects were observed. Maximum dose was 14 mg/h and treatment duration was 7 days. Primary outcome parameters were pain scores (Numeric Rating Scale) at baseline (T0), end of infusion (T1), and approximately 4 weeks postinfusion (T2). Patients were categorized as responder/nonresponder at T1 and T2. Patients were considered a responder in case there was pain score reduction of greater than or equal to 2 points or if treatment was reported as successful. Results: Forty‐eight patients were included. Mean disease duration was 5 years (interquartile range [IQR] = 6 years). Median pain score significantly decreased from 8 (IQR = 2) at T0 to 6 (IQR = 4) at T1 (p < 0.001). At T1, 62% of the patients were responders. At T2, 48% of the patients remained a responder. A significant proportion of the responders at T1 turned into nonresponders at T2 (p = 0.03). Conclusion: In a group of patients with CRPS with refractory pain, low‐dose intravenous S‐ketamine treatment resulted in effective pain relief during infusion. Although a significant proportion of initial responders became nonresponders at follow‐up, half of the patients were still a responder at ~ 4 weeks postinfusion. Further research is needed to investigate mechanisms responsible for pain relief by S‐ketamine infusions and to ascertain possible predictors of response to the treatment. [ABSTRACT FROM AUTHOR]
Copyright of Pain Practice is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Effect of intravenous low‐dose S‐ketamine on pain in patients with Complex Regional Pain Syndrome: A retrospective cohort study.
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Pain+Practice%22&quot;&gt;Pain Practice&lt;/searchLink&gt;. Nov2021, Vol. 21 Issue 8, p890-897. 8p. 1 Diagram, 3 Charts, 1 Graph.
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  Data: Objective: The objective of this study was to assess the effectiveness of a low‐dose intravenous S‐ketamine treatment on refractory pain in patients with Complex Regional Pain Syndrome (CRPS). Methods: In this retrospective study, patients with CRPS who received intravenous S‐ketamine from March 2010 to April 2019 were included. According to our inpatient protocol, S‐ketamine dose was increased until pain reduction was achieved or side effects were observed. Maximum dose was 14 mg/h and treatment duration was 7 days. Primary outcome parameters were pain scores (Numeric Rating Scale) at baseline (T0), end of infusion (T1), and approximately 4 weeks postinfusion (T2). Patients were categorized as responder/nonresponder at T1 and T2. Patients were considered a responder in case there was pain score reduction of greater than or equal to 2 points or if treatment was reported as successful. Results: Forty‐eight patients were included. Mean disease duration was 5 years (interquartile range [IQR] = 6 years). Median pain score significantly decreased from 8 (IQR = 2) at T0 to 6 (IQR = 4) at T1 (p &lt; 0.001). At T1, 62% of the patients were responders. At T2, 48% of the patients remained a responder. A significant proportion of the responders at T1 turned into nonresponders at T2 (p = 0.03). Conclusion: In a group of patients with CRPS with refractory pain, low‐dose intravenous S‐ketamine treatment resulted in effective pain relief during infusion. Although a significant proportion of initial responders became nonresponders at follow‐up, half of the patients were still a responder at ~ 4 weeks postinfusion. Further research is needed to investigate mechanisms responsible for pain relief by S‐ketamine infusions and to ascertain possible predictors of response to the treatment. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of Pain Practice is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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        Value: 10.1111/papr.13056
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      – Code: eng
        Text: English
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      Pagination:
        PageCount: 8
        StartPage: 890
    Subjects:
      – SubjectFull: Statistical significance
        Type: general
      – SubjectFull: Pain
        Type: general
      – SubjectFull: Pain measurement
        Type: general
      – SubjectFull: Retrospective studies
        Type: general
      – SubjectFull: Treatment duration
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      – SubjectFull: Mann Whitney U Test
        Type: general
      – SubjectFull: Treatment effectiveness
        Type: general
      – SubjectFull: Ketamine
        Type: general
      – SubjectFull: Descriptive statistics
        Type: general
      – SubjectFull: Complex regional pain syndromes
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      – SubjectFull: Intravenous injections
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      – SubjectFull: Data analysis software
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      – SubjectFull: Data analysis
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      – SubjectFull: Pain management
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              Text: Nov2021
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              Y: 2021
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