Salas, S., Frasca, M., Planchet-Barraud, B., Burucoa, B., Pascal, M., Lapiana, J.M., … Baumstarck, K. (2012). Ketamine analgesic effect by continuous intravenous infusion in refractory cancer pain: Considerations about the clinical research in palliative care. Journal of Palliative Medicine, 15(3), 287–293.doi: 10.1089/jpm.2011.0353
To assess the efficacy of continuous IV infusion of ketamine in patients suffering from opiate-refractory cancer pain admitted to palliative care units
Patients were computer randomized to either IV morphine plus ketamine or morphine plus placebo. Morphine could be titrated by 50% once daily. Evaluations were performed at baseline, 2 hours, 24 hours, and 48 hours after initiation of infusion. Ketamine was given at continuous infusion of 0.5mg/kg per day and increased to 1mg/kg per day if pain score did not improve after 24 hours.
This was a multisite study conducted in France.
This was a randomized, double blind, placebo-controlled study.
Pain did not significantly differ between the two groups. No significant differences were found in morphine changes, ESS scores, or satisfaction scores between the two groups.
The combination of morphine and ketamine did not improve pain or decrease opioid requirements.
Although ketamine did not improve pain scores in patients with opiate refractory pain, further studies are needed because of study limitations.