Use of Ketamine Infusions for Treatment of Complex Regional Pain Syndrome: A Systematic Review

AbstractBackgroundThis systematic review aims to review clinical studies on the use of ketamine infusion for patients with treatment-resistant Complex Regional Pain Syndrome (CRPS).MethodsThe following systematic review was registered on PROSPERO (CRD42021228470). Studies for the systematic review were identified through 3 databases; PubMed, CINAHL, and Cochrane Review. Inclusion criteria for studies consisted of randomized clinical trials or cohort studies that conducted trials on the use of ketamine infusion for pain relief in patients with Complex Regional Pain Syndrome (CRPS). Exclusion criteria for studies included any studies that were systematic review, meta-analyses, case reports, literature reviews, or animal studies. In the included studies, the primary outcome of interest was post drug administration pain score.ResultsIn this systematic review, 14 studies met the inclusion criteria and were reviewed. In these studies, the dosage of ketamine infusion used ranged from 0.15 mg/kg to 7mg/kg with primary indication being treatment of Complex Regional Pain Syndrome (CRPS). In 13 of the studies, ketamine infusion resulted in a decrease in pain scores and relief of symptoms.ConclusionsPatients who received Ketamine infusion for treatment-resistant CRPS self-reported adequate pain relief with treatment. This suggests that ketamine infusion may be a useful form of treatment for patients with no significant pain relief with other conservative measures. Future large-scale studies, including randomized double-blind placebo-controlled trials on the use of ketamine infusion for CRPS must be conducted in a large-scale population to further assess the effectiveness of ketamine infusion in these populations.</jats:sec

Medical Cannabis: A Review from the American Society of Pain and Neuroscience

Cannabinoids have recently gained a renewed interest due to their potential applicability to various medical conditions, specifically the management of chronic pain conditions. Unlike many other medications, medical cannabis is not associated with serious adverse events, and no overdose deaths have been reported. However, both safety and efficacy data for medical cannabis treatment of chronic, nonmalignant pain conditions are lacking. Therefore, representatives from the American Society of Pain and Neuroscience summarize the evidence, according to level and grade, for medical cannabis treatment of several different pain conditions. Treatment of cancer-related pain has prospective evidentiary support for the use of medical cannabis. Although 3 large and well-designed randomized controlled trials investigated cannabis treatment of cancer-related pain, the evidence yielded only a grade D recommendation. Neuropathic pain has been investigated in prospective studies, but a lack of high-quality evidence renders cannabis treatment for this indication a grade C recommendation. Both safety and efficacy data are lacking for use of medical cannabis to treat chronic nonmalignant pain conditions