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In Search of Solutions for Chronic Pain: A Meta-analysis of Ketamine Infusions

Nathan, Naveen MD

doi: 10.1213/ANE.0000000000004244
Infographics: Infographic
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Northwestern University Feinberg School of Medicine (n-nathan@northwestern.edu).

Published ahead of print 23 April 2019.

The Infographic is composed by Naveen Nathan, MD, Northwestern University Feinberg School of Medicine (n-nathan@northwestern.edu). Illustration by Naveen Nathan, MD.

The author declares no conflicts of interest.

Challenges to the management of chronic pain syndromes include a lack of reliable therapies that have acceptable side effect profiles. In light of the opiate crisis that compels the use of alternative therapies, ketamine, a well-known analgesic, has emerged as a viable adjunctive agent. Continuous infusions have been utilized in a variety of settings to treat pain. This infographic summarizes the findings of a systematic review and meta-analysis comparing ketamine infusion therapy to placebo in patients with neuropathic, nonneuropathic, and mixed chronic pain syndromes. A small reduction in pain scores was observed for up to 2 weeks after therapy. A notable increase in the relative risk of psychotomimetic phenomena and nausea was observed in ketamine-treated patients. For the full scope of the study, as well as limitations of trials used in the systematic review, the reader is strongly encouraged to explore the referenced study in this issue.

CI indicates confidence interval; MD, weighted mean difference in pain score.

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REFERENCES

1. Orhurhu V, Orhurhu MS, Bhatia A, Cohen SP. Ketamine infusions for chronic pain: a systematic review and meta-analysis of randomized controlled trials. Anesth Analg. 2019;129:241254.
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