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Optimizing the Treatment of CRPS With Ketamine
Journal article   Open access   Peer reviewed

Optimizing the Treatment of CRPS With Ketamine

Anthony F. Kirkpatrick, Abolfazl Saghafi, Kai Yang, Peihua Qiu, James Alexander, Egle Bavry and Robert Schwartzman
The Clinical journal of pain, v 36(7), pp 516-523
01 Jul 2020
PMID: 32243301
url
https://doi.org/10.1016/j.bpj.2012.11.341View
Published, Version of Record (VoR)Open Access (Publisher-Specific) Open
url
https://doi.org/10.1097/AJP.0000000000000831View
Published, Version of Record (VoR) Open

Abstract

Anesthesiology Clinical Neurology Life Sciences & Biomedicine Neurosciences & Neurology Science & Technology
Objective: This study aimed to develop a method that objectively measures the clinical benefits of ketamine infusions to treat complex regional pain syndrome (CRPS), thus making it possible, for the first time, to determine the optimal dosing of ketamine and duration of treatment to treat CRPS. Materials and Methods: All patients were diagnosed with hyperalgesia associated with CRPS. Patients underwent an outpatient, 4-day, escalating dose ketamine infusion. Hyperalgesia was measured using pain thresholds. Clinical outcome was determined without knowledge of the patient's pain thresholds throughout treatment. Results: We found a correlation between pain thresholds and the intensity of pain reported by the patient at various sites of the body. We found that clinical outcomes correlated with improvement in pain thresholds. There was a plateau in pain thresholds between days 3 and 4 for the lower extremities. There was no plateau in pain thresholds observed for the upper extremities. Discussion: Our findings suggest that 4 days of treatment are sufficient for the treatment of CRPS of the lower extremities. For the upper extremities, >4 days may be required. Our study is the first to utilize quantitative sensory testing to direct the treatment of a chronic pain disorder.

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Collaboration types
Domestic collaboration
Web of Science research areas
Anesthesiology
Clinical Neurology
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