Miranda Hetrick, Emily Casey, Jacob Radcliff, Tanya Uritsky
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引用次数: 0
摘要
氯胺酮是一种 N 甲基 D-天冬氨酸(NMDA)受体拮抗剂,用于以亚麻醉剂量治疗疼痛。氯胺酮对阿片类药物耐受性高且出现阿片类药物引起的痛觉减退的患者有益。本研究描述了一家大型学术医院使用氯胺酮口服镇痛的特点,并报告了住院患者的安全结果。这项研究是对接受口服氯胺酮治疗的 18 岁或以上患者的电子健康记录(EHR)进行回顾性分析。主要终点是氯胺酮起始剂量和治疗期间最大剂量(毫克/千克/天)的中位数。次要结果包括口服吗啡毫克当量(MMEs)、丁丙诺啡剂量、治疗第一天和最后一天的最低和最高疼痛评分。还报告了安全性终点。起始剂量中位数为 1 毫克/千克/天,最大剂量中位数为 1.6 毫克/千克/天。从口服氯胺酮治疗的第一天到最后一天,中位MMEs有所下降。研究对象的安全事件发生率总体较低。口服氯胺酮镇痛安全,患者接受氯胺酮的剂量处于既定治疗范围的下限。口服氯胺酮镇痛的疗效和安全性评估有待进一步研究。
Characterization of Oral Ketamine Use: A Retrospective Review.
Ketamine is an N-methyl D-aspartate (NMDA) receptor antagonist used to treat pain at subanesthetic doses. Ketamine is beneficial for pain control in patients who have a high tolerance to opioids and are experiencing opioid-induced hyperalgesia. This study characterizes oral ketamine use for analgesia at a large academic hospital and reports safety outcomes for hospitalized patients. This study was a retrospective electronic health record (EHR) review of patients ≥ 18 years or older receiving oral ketamine. The primary endpoint was median ketamine starting dose and maximum dose (mg/kg/day) during treatment duration. Secondary outcomes included oral Morphine Milligram Equivalents (MMEs), buprenorphine dose, minimum and maximum pain scores on the first and last day of therapy. Safety endpoints were reported. The median starting dose was 1 mg/kg/day, and the median maximum dose was 1.6 mg/kg/day. Median MMEs decreased from the first day to the last day of oral ketamine therapy. The study population experienced a low incidence of safety events overall. Oral ketamine was administered safely for analgesia, with patients receiving ketamine doses that were on the lower end of the established therapeutic range. Evaluation of the efficacy and safety of oral ketamine use for analgesia should be further studied.