The effectiveness of intravenous ketamine and lidocaine on peripheral neuropathic pain

Kvarnström, Ann; Karlsten, Rolf; Quiding, Hans; Emanuelsson, Britt‐Marie; Gordh, Torsten

doi:10.1034/j.1399-6576.2003.00187.x

Cited by 88 publications

(93 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Multiple peripheral as well as central mechanisms can contribute to the pathogenesis of neuropathic pain, including postherpetic neuralgia [12], and drug testing has been carried out to clarify the pathophysiological mechanisms underlying such chronic pain [13,14]. Morphine is effective in relieving nociceptive pain by acting on the µ-opioid receptor in the spinal cord and brain [13,15].…”

Section: Discussionmentioning

confidence: 99%

“…Lidocaine can inhibit neuronal hyperexcitability of damaged peripheral primary afferents characterized by spontaneous (ectopic) impulses and repetitive firing [12,14,21]. Excitatory amino acids acting on the N-methyl-d-aspartic acid (NMDA) receptor may contribute to central sensitization, and the NMDA receptor antagonist ketamine is often effective in relieving neuropathic pain in which such central mechanisms are involved [12][13][14]22].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Intravenous infusion of adenosine 5?-triphosphate alleviated a disabling postherpetic neuralgia

Hayashida

Sato

Fukunaga

et al. 2004

Journal of Anesthesia

View full text Add to dashboard Cite

the lateral site of the right leg as well as the dorsal and plantar sites of the right foot. The patient was initially treated at a dermatology clinic with oral valaciclovir (an antiviral agent) and diclofenac (an anti-inflammatory agent), and subsequently, with diclofenac alone for several weeks. Within a month of its onset, the pain in the leg and the dorsum of the foot subsided concomitantly with the skin rash healing. However, severe pain in the plantar site of the foot persisted.Three months after the initial onset, the patient presented at our pain clinic, in a wheelchair, because of intractable pain with severe tactile allodynia on the sole and on the heel of the right foot, which was so severe that it prevented her from walking normally. Resting spontaneous pain was moderate, being rated at 50 mm/ 100 mm on the visual analog scale (VAS). However, marked tactile allodynia was observed on the right heel, which was rated at 91/100 mm. Because of the severe touch-evoked allodynia, she could not stand on the right foot, nor could she wear a sock or shoe on the right foot. She could hardly walk, limping and relying mostly on the left foot, stepping on the right tiptoe, and she wore beach sandals. She was treated initially with oral amitriptyline and repeated (caudal) epidural blocks, which resulted in only a slight improvement in her pain status.Five months after the onset of pain, she was admitted to our hospital to study the mechanisms underlying her pain condition, and to seek potentially effective therapeutic measures. After obtaining institutional review board approval and written informed consent from the patient, we assessed various intravenous (IV) drugs for analgesic efficacy. Because the severe tactile allodynia was elicited most prominently when she was trying to walk, she was asked to rate her pain using VAS both at rest (for spontaneous pain) and when standing/stepping (for evoked tactile allodynia) before, during, and after administration of each test drug.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Intravenous infusion of adenosine 5?-triphosphate alleviated a disabling postherpetic neuralgia

Hayashida

Sato

Fukunaga

et al. 2004

Journal of Anesthesia

View full text Add to dashboard Cite

show abstract

“…Recent trial of dextromethorphan in combination with quinidine had promising results in patients with PDN (92). In addition, ketamine administered by intravenous (93) and intranasal (94) routes showed efficacy in NP, but caused somnolence and dizziness. Although memantine has low side effect profile owing to its rapid blocking/unblocking kinetics at the NMDARs, it seems to exhibit only little or no effect on patients with PDN and PHN (95).…”

Section: N-methyl-d-aspartate Receptor Antagonistsmentioning

confidence: 99%

Pharmacological Management of Neuropathic Pain: Current Trends and Possible Approaches

Kumar¹,

Pottabathini²,

Bhatnagar³

et al. 2016

Arch Neurosci

View full text Add to dashboard Cite

Context: Neuropathic pain (NP) is a chronic debilitating painful condition with complex pathophysiology and inadequate treatment. Conventional pharmacological approaches and currently available drugs only provide marginal pain relief and cause significant adverse effects. The present manuscript is an attempt to summarize the existing data and possible pharmacological approaches available for NP.Evidence Acquisition: Information was collected from Google Scholar, Cochrane and PubMed databases, Scopus and directory of open access journals. Neuropathic pain, chronic pain, diabetic neuropathy, pathophysiology and current recommendations were the terms used to search the literature. Data from relevant animal and randomized controlled studies were selected to get the up to date information of the currently available pharmacological approaches. A note on future approaches was added based on the recent animal and human studies. Results:The current review made a significant attempt to focus on the mode of action, required dosage, advantages and the side effect profiles of currently available drugs used, or in investigational phases and their possible combinations to manage NP. Efforts are made to cover arise of NP because of diabetes and its management. At the end, authors made an attempt to cover the various therapeutic options that are currently explored for future drug development. Conclusions:The available pharmacological approaches are effective on one or other types of chronic pain. But the inadequate pain relief and limitations with each class of drugs raises the need to develop better therapeutic approaches and also understand the pathology better. The present review may be helpful to researchers intending to focus on newer therapeutic strategies and targets to manage NP.Keywords: Chronic Pain, Antidepressants, Anti-Epileptics, Opioids, Therapeutic Management ContextNeuropathic pain (NP) is a severe debilitating form of pain which originates as a consequence of lesion or disease pertaining to somatosensory system. The term lesion refers to the actual/potential damage of neurons identified via laboratory diagnostic procedure, whereas the term disease refers to the known cause for the lesion. NP is a clinical description which helps to identify the possible underlying causes. Etiology of NP ranges from traumatic nerve damage/compression, diabetes, cancer and its chemotherapy, viral infections such as HIV, alcohol and other toxin exposure, surgical amputations, etc. Furthermore, pain originated from a lesion or disease in central or peripheral somatosensory nervous system leads to the categorization of NP into central NP or peripheral NP, respectively. NP is associated with a wide range of sensory changes as described in Table 1 (1). Currently available drugs provide only marginal pain relief and are associated with various adverse effects.Therefore, understanding the current knowledge about complex pathology of NP and available drugs helps the researchers to rationalize the therapeutic approaches. This also...

show abstract

“…There are at least 9 randomized, double-blind trials demonstrating the efficacy of ketamine in NP [66][67][68][69][70][71][72][73][74][75]. In patients with post-nerve injury NP, ketamine administered IV has shown significant reduction in pain and allodynia as compared to placebo [66-70, 73, 74] as well as compared to morphine [73].…”

Section: Literature On Ketamine Use In Peripheral Neuropathic Painmentioning

confidence: 99%

The Use of Ketamine in Neuropathic Pain

O’Brien

Pangarkar

Prager

2014

Curr Phys Med Rehabil Rep

View full text Add to dashboard Cite

Hyperactivity of N-methyl-D-aspartate (NMDA) receptors may be one of the factors in the genesis of neuropathic pain (NP). Ketamine is a dissociative anesthetic and analgesic that is the most potent NMDA receptor antagonist currently available for human use. There is a growing body of literature for three decades suggesting efficacy of subanaesthetic doses of ketamine in the treatment of NP, particularly the pain in complex regional pain syndromes. The primary limitations of ketamine use are secondary to psychotomimetic and, to a lesser extent, sympathetic activation. The purpose of this article is to review the history, pharmacology, pharmacodynamics, clinical benefits, and limitations of ketamine for treatment of NP. Methods of administration and management of adverse effects are highlighted based on the clinical experience of the authors.

show abstract

The effectiveness of intravenous ketamine and lidocaine on peripheral neuropathic pain

Abstract: Ketamine showed a significant analgesic effect. The clinical usefulness is, however, limited by disturbing side-effects.

Cited by 88 publications

References 46 publications

Intravenous infusion of adenosine 5?-triphosphate alleviated a disabling postherpetic neuralgia

Intravenous infusion of adenosine 5?-triphosphate alleviated a disabling postherpetic neuralgia

Pharmacological Management of Neuropathic Pain: Current Trends and Possible Approaches

The Use of Ketamine in Neuropathic Pain

Contact Info

Product

Resources

About