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Ketamine infusion therapy for chronic pain management in South Korea: A national survey for pain physicians with a narrative review

Although ketamine infusion therapy (KIT) has been used extensively for the treatment of chronic persistent pain, there remains high heterogeneity in the administration protocols. The aim of this study was to assess the current clinical use and the infusion protocols of KIT in South Korea and to comp...

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Autores principales: Anaya, Anyela Marcela Castañeda, Choi, Jae-Kyu, Lee, Chang-soon, Oh, Euna, Kim, Youngwon, Moon, Jee Youn, Lee, Pyung Bok, Kim, Yong-Chul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6133568/
https://www.ncbi.nlm.nih.gov/pubmed/30095626
http://dx.doi.org/10.1097/MD.0000000000011709
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author Anaya, Anyela Marcela Castañeda
Choi, Jae-Kyu
Lee, Chang-soon
Oh, Euna
Kim, Youngwon
Moon, Jee Youn
Lee, Pyung Bok
Kim, Yong-Chul
author_facet Anaya, Anyela Marcela Castañeda
Choi, Jae-Kyu
Lee, Chang-soon
Oh, Euna
Kim, Youngwon
Moon, Jee Youn
Lee, Pyung Bok
Kim, Yong-Chul
author_sort Anaya, Anyela Marcela Castañeda
collection PubMed
description Although ketamine infusion therapy (KIT) has been used extensively for the treatment of chronic persistent pain, there remains high heterogeneity in the administration protocols. The aim of this study was to assess the current clinical use and the infusion protocols of KIT in South Korea and to compare the protocol details with previous relevant studies. In the first phase, an online survey about KIT, including protocol information, was distributed to pain physicians managing chronic pain patients at 47 teaching hospitals registered in the Korean Pain Society. In the second phase, a review of the KIT protocols in previous clinical studies was conducted and compared with the survey results. Among 47 institutions, 35 replied; among them, 25 institutions performed KIT on an outpatient basis. The administration protocol for KIT varied greatly among institutions: the total infusion dose of ketamine ranged from 3.5 to 140 mg/70 kg, with a mode of 70 mg [interquartile range (IQR): 62.0; 8.0–70.0 mg] administered in 1 to 3 hours. In 10 previous studies of outpatient KIT, the total dose of ketamine ranged from 12.6 to 98 mg/70 kg, with a mode of 35 mg [IQR: 40 mg; 23–63 mg] given in 1 to 4 hours, which was significantly lower than in our results (P = .01). In the survey, physicians listed hallucination as the most frequent side effect. Although KIT is used in Korean pain centers, there is wide variation regarding the specific infusion protocols. The total dose of ketamine used in South Korea is significantly higher than the general recommendations for outpatient management and may compromise patient safety. The results of this survey reinforce the need for specific guidelines for KIT in managing chronic pain that counterbalance its risks and benefits.
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spelling pubmed-61335682018-09-19 Ketamine infusion therapy for chronic pain management in South Korea: A national survey for pain physicians with a narrative review Anaya, Anyela Marcela Castañeda Choi, Jae-Kyu Lee, Chang-soon Oh, Euna Kim, Youngwon Moon, Jee Youn Lee, Pyung Bok Kim, Yong-Chul Medicine (Baltimore) Research Article Although ketamine infusion therapy (KIT) has been used extensively for the treatment of chronic persistent pain, there remains high heterogeneity in the administration protocols. The aim of this study was to assess the current clinical use and the infusion protocols of KIT in South Korea and to compare the protocol details with previous relevant studies. In the first phase, an online survey about KIT, including protocol information, was distributed to pain physicians managing chronic pain patients at 47 teaching hospitals registered in the Korean Pain Society. In the second phase, a review of the KIT protocols in previous clinical studies was conducted and compared with the survey results. Among 47 institutions, 35 replied; among them, 25 institutions performed KIT on an outpatient basis. The administration protocol for KIT varied greatly among institutions: the total infusion dose of ketamine ranged from 3.5 to 140 mg/70 kg, with a mode of 70 mg [interquartile range (IQR): 62.0; 8.0–70.0 mg] administered in 1 to 3 hours. In 10 previous studies of outpatient KIT, the total dose of ketamine ranged from 12.6 to 98 mg/70 kg, with a mode of 35 mg [IQR: 40 mg; 23–63 mg] given in 1 to 4 hours, which was significantly lower than in our results (P = .01). In the survey, physicians listed hallucination as the most frequent side effect. Although KIT is used in Korean pain centers, there is wide variation regarding the specific infusion protocols. The total dose of ketamine used in South Korea is significantly higher than the general recommendations for outpatient management and may compromise patient safety. The results of this survey reinforce the need for specific guidelines for KIT in managing chronic pain that counterbalance its risks and benefits. Wolters Kluwer Health 2018-08-10 /pmc/articles/PMC6133568/ /pubmed/30095626 http://dx.doi.org/10.1097/MD.0000000000011709 Text en Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0
spellingShingle Research Article
Anaya, Anyela Marcela Castañeda
Choi, Jae-Kyu
Lee, Chang-soon
Oh, Euna
Kim, Youngwon
Moon, Jee Youn
Lee, Pyung Bok
Kim, Yong-Chul
Ketamine infusion therapy for chronic pain management in South Korea: A national survey for pain physicians with a narrative review
title Ketamine infusion therapy for chronic pain management in South Korea: A national survey for pain physicians with a narrative review
title_full Ketamine infusion therapy for chronic pain management in South Korea: A national survey for pain physicians with a narrative review
title_fullStr Ketamine infusion therapy for chronic pain management in South Korea: A national survey for pain physicians with a narrative review
title_full_unstemmed Ketamine infusion therapy for chronic pain management in South Korea: A national survey for pain physicians with a narrative review
title_short Ketamine infusion therapy for chronic pain management in South Korea: A national survey for pain physicians with a narrative review
title_sort ketamine infusion therapy for chronic pain management in south korea: a national survey for pain physicians with a narrative review
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6133568/
https://www.ncbi.nlm.nih.gov/pubmed/30095626
http://dx.doi.org/10.1097/MD.0000000000011709
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