Jessica B Emshoff, Kolby Verrona, Ashley Conger, Richard Chan
{"title":"Ketamine as an Adjunct Therapy for Refractory Cancer Pain: A Case Report.","authors":"Jessica B Emshoff, Kolby Verrona, Ashley Conger, Richard Chan","doi":"10.1080/15360288.2025.2546101","DOIUrl":null,"url":null,"abstract":"<p><p>Adequate analgesia in patients with advanced cancer can pose a significant clinical challenge, particularly when refractory to conventional opioid-based therapies. Refractory cancer pain, characterized by inadequate relief despite optimized opioid regimens or intolerable side effects, often prompts alternative treatments to improve patient's quality of life. Ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, may represent a useful adjunctive therapy due to its unique analgesic properties and potential to mitigate opioid tolerance and hyperalgesia. While traditionally recognized for its anesthetic and dissociative effects, low-dose, subanesthetic ketamine can be useful in palliative care to manage severe, intractable pain. This article reviews the unique pharmacologic properties of ketamine and describes a case report recounting ketamine use in a patient with refractory cancer pain, highlighting therapeutic potential and clinical implications in the palliative setting.</p>","PeriodicalId":16645,"journal":{"name":"Journal of Pain & Palliative Care Pharmacotherapy","volume":" ","pages":"1-7"},"PeriodicalIF":1.0000,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Pain & Palliative Care Pharmacotherapy","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1080/15360288.2025.2546101","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Adequate analgesia in patients with advanced cancer can pose a significant clinical challenge, particularly when refractory to conventional opioid-based therapies. Refractory cancer pain, characterized by inadequate relief despite optimized opioid regimens or intolerable side effects, often prompts alternative treatments to improve patient's quality of life. Ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, may represent a useful adjunctive therapy due to its unique analgesic properties and potential to mitigate opioid tolerance and hyperalgesia. While traditionally recognized for its anesthetic and dissociative effects, low-dose, subanesthetic ketamine can be useful in palliative care to manage severe, intractable pain. This article reviews the unique pharmacologic properties of ketamine and describes a case report recounting ketamine use in a patient with refractory cancer pain, highlighting therapeutic potential and clinical implications in the palliative setting.
在晚期癌症患者中,适当的镇痛可能会带来重大的临床挑战,特别是当传统的阿片类药物治疗难治性时。难治性癌症疼痛的特点是,尽管优化了阿片类药物治疗方案或难以忍受的副作用,但仍不能充分缓解,因此往往需要替代治疗来改善患者的生活质量。氯胺酮是一种n -甲基- d -天冬氨酸(NMDA)受体拮抗剂,由于其独特的镇痛特性和减轻阿片耐受性和痛觉过敏的潜力,可能是一种有用的辅助治疗。虽然传统上认为氯胺酮具有麻醉和解离作用,但低剂量亚麻醉氯胺酮可用于姑息治疗,以治疗严重的顽固性疼痛。本文回顾了氯胺酮独特的药理学特性,并描述了一个病例报告,叙述了氯胺酮在难治性癌症疼痛患者中的应用,强调了治疗潜力和临床意义。