Ketamine in Chronic Pain: A Review.
Ana Faísco, Rita Dinis, Tânia Seixas, Luís Lopes
Cureus February 1, 2024 DOI: 10.7759/cureus.53365 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Intervention | Ketamine |
| Dose | sub-anesthetic doses |
| Topics | Ketamine Esketamine |
| Keywords | Cancer pain Chronic postoperative pain Non-oncological pain Ketamine therapy Chronic pain management Pain medicine Anesthesia research Medical breakthroughs |
| Citations | 8 |
| Key findings | Ketamine provides well-documented short-term analgesic effects and reduces postoperative chronic pain and opioid consumption, but evidence for long-term benefits is limited and further investigation into safety is needed. |
Abstract
Ketamine has been used in the treatment of several pain syndromes, particularly those with a relevant neuropathic component. Sub-anesthetic doses of ketamine produce a potent analgesic effect, due to its inhibition of N-methyl-D-aspartate receptors and enhancement of descending inhibitory pathways. Its short-term analgesic effect is well-documented perioperatively, with an associated reduction in postoperative chronic pain and opioid consumption. Despite some evidence regarding its long-term benefits, the number of clinical studies is still limited. In addition to its analgesic effects, ketamine also possesses an anti-depressive action, which might be useful in the treatment of chronic pain patients. Several side effects have been described, the psychomimetic ones being the most relevant due to their impact on treatment adhesion. At present, co-administration of ketamine and benzodiazepines or α2-agonists facilitates its clinical application. Despite current evidence and increasing use, further investigation is still needed regarding its long-term safety profile and clearer risk-benefit analysis.
Comparable studies
Other narrative reviews on ketamine, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Ketamine and Ketamine Metabolite Pharmacology: Insights into Therapeutic Mechanisms | 2018 | Review | |
| Mechanisms of Ketamine Action as an Antidepressant | 2018 | Review | |
| Synthesizing the Evidence for Ketamine and Esketamine in Treatment-Resistant Depression: An International Expert Opinion on the Available Evidence and Implementation Adults with treatment-resistant depression | 2021 | Review | |
| Ketamine Pharmacology: An Update (Pharmacodynamics and Molecular Aspects, Recent Findings) | 2013 | Review | |
| A Consensus Statement on the Use of Ketamine in the Treatment of Mood Disorders | 2017 | Review and consensus statement |
Citations in the library
Cited by 4
- (R)-(-)-Ketamine: The Promise of a Novel Treatment for Psychiatric and Neurological Disorders. International Journal of Molecular Sciences June 20, 2024
- Role of ketamine in the treatment of substance use disorders: A systematic review. Journal of Substance Use and Addiction Treatment August 1, 2025
- Ketamine Infusion for Complex Regional Pain Syndrome Treatment: A Narrative Review. Current Pain and Headache Reports January 14, 2025
- Ketamine: An emerging agent in the management of neuropsychiatric disorders. Asian Journal of Psychiatry April 1, 2025
Cites 5
- A Randomized Trial of an N-methyl-D-aspartate Antagonist in Treatment-Resistant Major Depression Archives of General Psychiatry August 1, 2006
- Use and efficacy of low-dose ketamine in the management of acute postoperative pain: a review of current techniques and outcomes Pain August 1, 1999
- Taming the Ketamine Tiger Anesthesiology August 6, 2010
- Psychedelic Effects of Ketamine in Healthy Volunteers Anesthesiology 1998
- Revising a Dogma: Ketamine for Patients with Neurological Injury? Anesthesia & Analgesia July 12, 2005