Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Scholz, A.
Ketamin in der Behandlung tumorassoziierter Schmerzen Systematic Review
[ Diplomarbeit/Master Thesis ] Medizinische Universität Graz; 2009. pp.71.
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Sandner-Kiesling Andreas
- Strohscheer Imke
- Altmetrics:
- Abstract:
- Background: Ketamine is being used increasingly as an adjuvant to opioids in the treatment of cancer pain, mainly without guidelines regarding dosages and indications. We conducted a systematic review to examine the available evidence of using ketamine in the treatment of cancer pain. Methods: A limited systematic review including randomized, controlled studies, controlled clinical studies and case reports was performed. Studies were identified by a database search which used the Cochrane Library (Issue 3, 2008), OvidMEDLINE (1990- 2008 week 44), PubMed (1985- 2008 week 44) and Embase (1988-2008 week 44). Using the operators ''Ketamine AND Cancer AND Pain''. Reference lists from review articles and already identified papers were handsearched. All studies and case reports which used ketamine for the therapy of cancer pain in adult patients were included. Results: Four randomized, controlled studies, eight controlled clinical trials, two chart reviews and 16 case reports including 19 patients in total were identified. We found evidence grade I for the use of oral, epidural and intrathecal use in three studies with the indication ''neuropathic pain'', ''terminal'' or ''refractory cancer pain''. The studies included between 30 and 48 patients. In all studies, the most common application is the intravenous way with dosages ranging from 1 mg/kg up to 15 mg/kg per 24 hours. Other common applications are the oral use of ketamine in dosages from 1 mg/kg to 1,5 mg/kg per 24 hours and the subcutaneous application of 1- 15 mg/kg ketamine per 24 hours. We found no clear evidence for the dosages and especially indications. Conclusion: Throughout all studies and case reports show that ketamine has a good effect on cancer pain. But high quality, randomized, controlled trials with larger numbers of participants are still needed to provide stronger evidence for ketamine use in cancer pain regarding the dosages and the indications.