Narrative Review: Low-Dose Ketamine for Pain Management
Pain is the leading cause of medical consultations and occurs in 50–70% of emergency department visits. To date, several drugs have been used to manage pain. The clinical use of ketamine began in the 1960s and it immediately emerged as a manageable and safe drug for sedation and anesthesia. The anal...
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-05-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/9/3256 |
| _version_ | 1797602331884257280 |
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| author | Alessandro Riccardi Mario Guarino Sossio Serra Michele Domenico Spampinato Simone Vanni Dana Shiffer Antonio Voza Andrea Fabbri Fabio De Iaco |
| author_facet | Alessandro Riccardi Mario Guarino Sossio Serra Michele Domenico Spampinato Simone Vanni Dana Shiffer Antonio Voza Andrea Fabbri Fabio De Iaco |
| author_sort | Alessandro Riccardi |
| collection | DOAJ |
| description | Pain is the leading cause of medical consultations and occurs in 50–70% of emergency department visits. To date, several drugs have been used to manage pain. The clinical use of ketamine began in the 1960s and it immediately emerged as a manageable and safe drug for sedation and anesthesia. The analgesic properties of this drug were first reported shortly after its use; however, its psychomimetic effects have limited its use in emergency departments. Owing to the misuse and abuse of opioids in some countries worldwide, ketamine has become a versatile tool for sedation and analgesia. In this narrative review, ketamine’s role as an analgesic is discussed, with both known and new applications in various contexts (acute, chronic, and neuropathic pain), along with its strengths and weaknesses, especially in terms of psychomimetic, cardiovascular, and hepatic effects. Moreover, new scientific evidence has been reviewed on the use of additional drugs with ketamine, such as magnesium infusion for improving analgesia and clonidine for treating psychomimetic symptoms. Finally, this narrative review was refined by the experience of the Pain Group of the Italian Society of Emergency Medicine (SIMEU) in treating acute and chronic pain with acute manifestations in Italian Emergency Departments. |
| first_indexed | 2024-03-11T04:15:35Z |
| format | Article |
| id | doaj.art-d29c5acfb6a24ede849c690624ba7b88 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T04:15:35Z |
| publishDate | 2023-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-d29c5acfb6a24ede849c690624ba7b882023-11-17T23:12:47ZengMDPI AGJournal of Clinical Medicine2077-03832023-05-01129325610.3390/jcm12093256Narrative Review: Low-Dose Ketamine for Pain ManagementAlessandro Riccardi0Mario Guarino1Sossio Serra2Michele Domenico Spampinato3Simone Vanni4Dana Shiffer5Antonio Voza6Andrea Fabbri7Fabio De Iaco8Emergency Department, Ospedale di Imperia, 18100 Imperia, ItalyEmergency Department, Centro Traumatologico Ortopedico, Azienda Ospedaliera di Rilievo Nazionale dei Colli, 80131 Napoli, ItalyEmergency Department, Maurizio Bufalini Hospital, 47522 Cesena, ItalyDepartment of Translational Medicine and for Romagna, University of Ferrara, 44124 Ferrara, ItalyDipartimento Emergenza e Area Critica, Azienda USL Toscana Centro Struttura Complessa di Medicina d’Urgenza, 50053 Empoli, ItalyEmergency Department, Humanitas University, Via Rita Levi Montalcini 4, 20089 Milan, ItalyEmergency Department, IRCCS Humanitas Research Hospital, 20089 Milan, ItalyEmergency Department, AUSL Romagna, Presidio Ospedaliero Morgagni-Pierantoni, 47121 Forlì, ItalyEmergency Department, Ospedale Maria Vittoria, 10144 Turin, ItalyPain is the leading cause of medical consultations and occurs in 50–70% of emergency department visits. To date, several drugs have been used to manage pain. The clinical use of ketamine began in the 1960s and it immediately emerged as a manageable and safe drug for sedation and anesthesia. The analgesic properties of this drug were first reported shortly after its use; however, its psychomimetic effects have limited its use in emergency departments. Owing to the misuse and abuse of opioids in some countries worldwide, ketamine has become a versatile tool for sedation and analgesia. In this narrative review, ketamine’s role as an analgesic is discussed, with both known and new applications in various contexts (acute, chronic, and neuropathic pain), along with its strengths and weaknesses, especially in terms of psychomimetic, cardiovascular, and hepatic effects. Moreover, new scientific evidence has been reviewed on the use of additional drugs with ketamine, such as magnesium infusion for improving analgesia and clonidine for treating psychomimetic symptoms. Finally, this narrative review was refined by the experience of the Pain Group of the Italian Society of Emergency Medicine (SIMEU) in treating acute and chronic pain with acute manifestations in Italian Emergency Departments.https://www.mdpi.com/2077-0383/12/9/3256ketaminepainemergency departments |
| spellingShingle | Alessandro Riccardi Mario Guarino Sossio Serra Michele Domenico Spampinato Simone Vanni Dana Shiffer Antonio Voza Andrea Fabbri Fabio De Iaco Narrative Review: Low-Dose Ketamine for Pain Management Journal of Clinical Medicine ketamine pain emergency departments |
| title | Narrative Review: Low-Dose Ketamine for Pain Management |
| title_full | Narrative Review: Low-Dose Ketamine for Pain Management |
| title_fullStr | Narrative Review: Low-Dose Ketamine for Pain Management |
| title_full_unstemmed | Narrative Review: Low-Dose Ketamine for Pain Management |
| title_short | Narrative Review: Low-Dose Ketamine for Pain Management |
| title_sort | narrative review low dose ketamine for pain management |
| topic | ketamine pain emergency departments |
| url | https://www.mdpi.com/2077-0383/12/9/3256 |
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