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Usefulness of the perfusion index for monitoring the response to intravenous ketamine infusion therapy in patients with complex regional pain syndrome.

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Title: Usefulness of the perfusion index for monitoring the response to intravenous ketamine infusion therapy in patients with complex regional pain syndrome.
Authors: Hong, Seung‐Wan, Hwang, Min‐Sik, Kim, Jae Hun, Kim, Minjung, Kim, Seong‐Hyop
Source: Pain Practice. Jun2023, Vol. 23 Issue 5, p535-542. 8p. 2 Charts, 5 Graphs.
Subjects: Intravenous therapy, Predictive tests, Confidence intervals, Extremities (Anatomy), Visual analog scale, Treatment effectiveness, Ketamine, Descriptive statistics, Research funding, Complex regional pain syndromes, Receiver operating characteristic curves, Sensitivity & specificity (Statistics), Cardiovascular disease diagnosis, Pain management, Evaluation
Abstract: Background: This study was performed to compare the perfusion index (PI) between affected and unaffected limbs in patients with complex regional pain syndrome (CRPS); it also evaluated the usefulness of the PI for monitoring the response to intravenous ketamine infusion therapy in such patients. Methods: In total, 46 patients with CRPS in one arm or leg were enrolled in this study. The PIs of the unaffected (PIControl) and affected (PICRPS) limbs were simultaneously evaluated before and after treatment. Results: PICRPS was significantly lower than PIControl at all time points. The change in PI from immediately before to 30 min after intravenous ketamine infusion therapy (TBefore and T30 min, respectively) in the affected limb was significantly correlated with the change in visual analog pain scale (VAS) between the two time points (r = 0.646, p < 0.001). The area under the curve for the changes in VAS and PICRPS between TBefore and T30 min was 0.928. The optimal threshold value for the change in PICRPS between TBefore and T30 min, to distinguish responders with a ≥ 50‐point reduction in VAS score from nonresponders, was 22.60% with a sensitivity of 0.811 (95% CI: 0.774–0.848) and a specificity of 0.889 (95% CI: 0.848–0.930). Thirty‐one patients showed a ≥ 50‐point reduction in VAS score [67% (95% CI: 54%–80%)] and 15 patients showed a < 50‐point reduction in VAS score [33% (95% CI: 20%–46%)]. Thirty patients showed an increased PI ≥ 22.60% [65% (95% CI: 50%–78%)] and 16 patients showed an increased PI < 22.60% [35% (95% CI: 22%–50%)]. Twenty‐seven patients had a ≥ 50‐point reduction in VAS score and an increased PI ≥ 22.60% [59% (95% CI: 44%–74%)]. Eleven patients had shown a < 50‐point pain reduction in VAS score and increased PI < 22.60% [24% (95% CI: 13%–37%)]. Conclusion: The PI significantly differed between affected and unaffected limbs in patients with CRPS. The PI may be useful for monitoring the response to intravenous ketamine therapy in patients with CRPS. [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: Usefulness of the perfusion index for monitoring the response to intravenous ketamine infusion therapy in patients with complex regional pain syndrome.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Hong%2C+Seung‐Wan%22&quot;&gt;Hong, Seung‐Wan&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Hwang%2C+Min‐Sik%22&quot;&gt;Hwang, Min‐Sik&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Kim%2C+Jae+Hun%22&quot;&gt;Kim, Jae Hun&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Kim%2C+Minjung%22&quot;&gt;Kim, Minjung&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Kim%2C+Seong‐Hyop%22&quot;&gt;Kim, Seong‐Hyop&lt;/searchLink&gt;
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Pain+Practice%22&quot;&gt;Pain Practice&lt;/searchLink&gt;. Jun2023, Vol. 23 Issue 5, p535-542. 8p. 2 Charts, 5 Graphs.
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  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Intravenous+therapy%22&quot;&gt;Intravenous therapy&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Predictive+tests%22&quot;&gt;Predictive tests&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Confidence+intervals%22&quot;&gt;Confidence intervals&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Extremities+%28Anatomy%29%22&quot;&gt;Extremities (Anatomy)&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Visual+analog+scale%22&quot;&gt;Visual analog scale&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Treatment+effectiveness%22&quot;&gt;Treatment effectiveness&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Ketamine%22&quot;&gt;Ketamine&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Descriptive+statistics%22&quot;&gt;Descriptive statistics&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Research+funding%22&quot;&gt;Research funding&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Complex+regional+pain+syndromes%22&quot;&gt;Complex regional pain syndromes&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Receiver+operating+characteristic+curves%22&quot;&gt;Receiver operating characteristic curves&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Sensitivity+%26+specificity+%28Statistics%29%22&quot;&gt;Sensitivity &amp; specificity (Statistics)&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Cardiovascular+disease+diagnosis%22&quot;&gt;Cardiovascular disease diagnosis&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Pain+management%22&quot;&gt;Pain management&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Evaluation%22&quot;&gt;Evaluation&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: This study was performed to compare the perfusion index (PI) between affected and unaffected limbs in patients with complex regional pain syndrome (CRPS); it also evaluated the usefulness of the PI for monitoring the response to intravenous ketamine infusion therapy in such patients. Methods: In total, 46 patients with CRPS in one arm or leg were enrolled in this study. The PIs of the unaffected (PIControl) and affected (PICRPS) limbs were simultaneously evaluated before and after treatment. Results: PICRPS was significantly lower than PIControl at all time points. The change in PI from immediately before to 30 min after intravenous ketamine infusion therapy (TBefore and T30 min, respectively) in the affected limb was significantly correlated with the change in visual analog pain scale (VAS) between the two time points (r = 0.646, p &lt; 0.001). The area under the curve for the changes in VAS and PICRPS between TBefore and T30 min was 0.928. The optimal threshold value for the change in PICRPS between TBefore and T30 min, to distinguish responders with a ≥ 50‐point reduction in VAS score from nonresponders, was 22.60% with a sensitivity of 0.811 (95% CI: 0.774–0.848) and a specificity of 0.889 (95% CI: 0.848–0.930). Thirty‐one patients showed a ≥ 50‐point reduction in VAS score [67% (95% CI: 54%–80%)] and 15 patients showed a &lt; 50‐point reduction in VAS score [33% (95% CI: 20%–46%)]. Thirty patients showed an increased PI ≥ 22.60% [65% (95% CI: 50%–78%)] and 16 patients showed an increased PI &lt; 22.60% [35% (95% CI: 22%–50%)]. Twenty‐seven patients had a ≥ 50‐point reduction in VAS score and an increased PI ≥ 22.60% [59% (95% CI: 44%–74%)]. Eleven patients had shown a &lt; 50‐point pain reduction in VAS score and increased PI &lt; 22.60% [24% (95% CI: 13%–37%)]. Conclusion: The PI significantly differed between affected and unaffected limbs in patients with CRPS. The PI may be useful for monitoring the response to intravenous ketamine therapy in patients with CRPS. [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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RecordInfo BibRecord:
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    Identifiers:
      – Type: doi
        Value: 10.1111/papr.13215
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 8
        StartPage: 535
    Subjects:
      – SubjectFull: Intravenous therapy
        Type: general
      – SubjectFull: Predictive tests
        Type: general
      – SubjectFull: Confidence intervals
        Type: general
      – SubjectFull: Extremities (Anatomy)
        Type: general
      – SubjectFull: Visual analog scale
        Type: general
      – SubjectFull: Treatment effectiveness
        Type: general
      – SubjectFull: Ketamine
        Type: general
      – SubjectFull: Descriptive statistics
        Type: general
      – SubjectFull: Research funding
        Type: general
      – SubjectFull: Complex regional pain syndromes
        Type: general
      – SubjectFull: Receiver operating characteristic curves
        Type: general
      – SubjectFull: Sensitivity & specificity (Statistics)
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      – SubjectFull: Cardiovascular disease diagnosis
        Type: general
      – SubjectFull: Pain management
        Type: general
      – SubjectFull: Evaluation
        Type: general
    Titles:
      – TitleFull: Usefulness of the perfusion index for monitoring the response to intravenous ketamine infusion therapy in patients with complex regional pain syndrome.
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            NameFull: Hong, Seung‐Wan
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            NameFull: Hwang, Min‐Sik
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            NameFull: Kim, Jae Hun
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            – D: 01
              M: 06
              Text: Jun2023
              Type: published
              Y: 2023
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