Keywords
acute pain
integrative review
How to Cite
Abstract
Ketamine's mechanism of action is to antagonize NMDA receptors (N-methyl-D-aspartate) with analgesic and sedative potential. Introduced in clinical practice about 30 years ago, acting as a monoanesthetic drug. In recent years indications for the use of ketamine have emerged, with discoveries of clinical placements including pain management and use in psychiatry. The main motivation for studying the use of ketamine stemmed from the possibility of making the drug an option in the treatment of pain, since the most used drugs, opioids, can cause complications and dependence. The objective is to analyze how the national and international scientific literature describes the use of ketamine in the management of acute pain. This is an integrative literature review with a qualitative approach, carried out according to the six steps recommended by Ganong. The bibliographic survey was carried out through an online search in the databases available in the Virtual Health Library (VHL), and in the Scientific Electronic Library Online (SciELO), PubMed and Embase databases. Based on Health Sciences Descriptors (DeCS/MeSH), the descriptors in Portuguese ketamina and pain acute, and in English ketamine and acute pain, were used in the selected databases. For the results, the articles selected for this research were analyzed in full format, clinical trial type and grouped into categories "use of ketamine in the emergency", "use of ketamine in postoperative pain" and "use of ketamine in the various pathologies that present acute pain". For critical analysis and discussion, 15 articles composed the study results. It is concluded that Ketamine is an effective adjuvant, as it prolongs the duration of other drugs in the management of acute pain in emergencies, has potential for analgesia, reduction of doses and side effects of opioids, its perioperative use should be considered and its use in low doses presents promising perspectives in postoperative analgesia.
References
ANWAR, Sibtain et al. Prolonged perioperative use of pregabalin and ketamine to prevent persistent pain after cardiac surgery. Anesthesiology, v. 131, n. 1, p. 119-131, 2019.
BARRETT, Tyler W.; SCHRIGER, David L. Move Over Morphine: Is Ketamine an Effective and Safe Alternative for Treating Acute Pain?: September 2015 Annals of Emergency Medicine Journal Club. Annals of Emergency Medicine, v. 66, n. 3, p. 336-337, 2015.
BEAUDOIN, Francesca L. et al. Low‐dose ketamine improves pain relief in patients receiving intravenous opioids for acute pain in the emergency department: results of a randomized, double‐blind, clinical trial. Academic Emergency Medicine, v. 21, n. 11, p. 1193-1202, 2014.
BEHDAD, Akbar; HOSSEINPOUR, Mehrdad; KHORASANI, Parastoo. Preemptive use of ketamine on post operative pain of appendectomy. The Korean journal of pain, v. 24, n. 3, p. 137, 2011.
BHUTTA, Adnan T. Ketamine: a controversial drug for neonates. In: Seminars in perinatology. WB Saunders, p. 303-308, 2007.
BOWERS, Karen J. et al. Ketamine as an adjunct to opioids for acute pain in the emergency department: a randomized controlled trial. Academic Emergency Medicine, v. 24, n. 6, p. 676-685, 2017.
BREIVIK, Harald. Ketamine has anti-hyperalgesic effects and relieves acute pain, but does not prevent persistent postoperative pain (PPP). Scandinavian journal of pain, v. 7, n. 1, p. 40-41, 2015.
BRINCK, Elina CV et al. Perioperative intravenous ketamine for acute postoperative pain in adults. Cochrane Database of Systematic Reviews, n. 12, 2018.
CARSTENSEN, Mads; MØLLER, A. M. Adding ketamine to morphine for intravenous patient-controlled analgesia for acute postoperative pain: a qualitative review of randomized trials. British journal of anaesthesia, v. 104, n. 4, p. 401-406, 2010.
DOAN, Lisa V.; WANG, Jing. An update on the basic and clinical science of ketamine analgesia. The Clinical journal of pain, v. 34, n. 11, p. 1077-1088, 2018.
DUCHARME, James. Acute Pain Management in the Year 2018-A Review. Journal of Acute Medicine, v. 8, n. 2, p. 53, 2018.
FOROUZAN, Arash et al. Comparison of the analgesic effect of intravenous ketamine versus intravenous morphine in reducing pain of renal colic patients: double-blind clinical trial study. Reviews on recent clinical trials, v. 14, n. 4, p. 280-285, 2019.
GAO, Mei; REJAEI, Damoon; LIU, Hong. Ketamine use in current clinical practice. Acta Pharmacologica Sinica, v. 37, n. 7, p. 865-872, 2016.
GHATE, Gauri; CLARK, Eric; VAILLANCOURT, Christian. Systematic review of the use of low-dose ketamine for analgesia in the emergency department. Canadian Journal of Emergency Medicine, v. 20, n. 1, p. 36-45, 2018.
HEIDARI, S. M.; AHMADI, M.; MEHRABI-KOUSHKI, A. Comparing the effect of preemptive intravenous acetaminophen and ketamine on postoperative pain. Journal of Isfahan Medical School, v. 33, n. 328, p. 368-377, 2015.
HOSSEININEJAD, Seyed Mohammad et al. Comparing the analgesic efficacy of morphine plus ketamine versus morphine plus placebo in patients with acute renal colic: A double-blinded randomized controlled trial. The American journal of emergency medicine, v. 37, n. 6, p. 1118-1123, 2019.
JONKMAN, Kelly et al. Ketamine for pain. F1000Research, v. 6, 2017.
KARLOW, Nicholas et al. A systematic review and meta‐analysis of ketamine as an alternative to opioids for acute pain in the emergency department. Academic Emergency Medicine, v. 25, n. 10, p. 1086-1097, 2018.
LEE, Eun Nam; LEE, Jae Hoon. The effects of low-dose ketamine on acute pain in an emergency setting: a systematic review and meta-analysis. PloS one, v. 11, n. 10, p. e0165461, 2016.
LI, Linda; VLISIDES, Phillip E. Ketamine: 50 years of modulating the mind. Frontiers in human neuroscience, v. 10, p. 612, 2016.
MACÊDO, Jacquelinny Lopes et al. Utilização da Cetamina no tratamento da dor aguda/crônica em seres humanos/Use of ketamine in the treatment of acute or chronic pain in humans. Revista multidisciplinar e de psicologia, v. 13, n. 44, p. 169-184, 2019.
MENDES, Karina Dal Sasso; SILVEIRA, Renata Cristina de Campos Pereira; GALVÃO, Cristina Maria. Revisão integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Texto & contexto enfermagem, v. 17, n. 4, p. 758-764, 2008.
MILLER, Joshua P. et al. Low-dose ketamine vs morphine for acute pain in the ED: a randomized controlled trial. The American journal of emergency medicine, v. 33, n. 3, p. 402-408, 2015.
MORADI FARSANI, Daroush et al. Comparison of the preventive effect of ketamine, paracetamol and metoclopramide on postoperative pain intensity in general anesthesia: a double-blind clinical trial. Scientific Journal of Kurdistan University of Medical Sciences, v. 24, n. 3, p. 134-142, 2019.
MORGAN, Celia JA; CURRAN, H. Valerie; Independent Scientific Committee On Drugs (ISCD). Ketamine use: a review. Addiction, v. 107, n. 1, p. 27-38, 2012.
MOTOV, Sergey et al. Intravenous subdissociative-dose ketamine versus morphine for acute geriatric pain in the emergency department: a randomized controlled trial. The American journal of emergency medicine, v. 37, n. 2, p. 220-227, 2019.
NAGHIPOUR, Bahman et al. Comparison of Ketamine and Tramadol in Management of Acute Pain; a Systematic Review. Archives of Academic Emergency Medicine, v. 8, n. 1, 2020.
NASCIMENTO, Daiana Ciléa Honorato; SAKATA, Rioko Kimiko. Dependência de opióide em pacientes com dor crônica. Revista dor, v. 12, n. 2, p. 160-165, 2011.
PELTONIEMI, Marko A. et al. Ketamine: a review of clinical pharmacokinetics and pharmacodynamics in anesthesia and pain therapy. Clinical pharmacokinetics, v. 55, n. 9, p. 1059-1077, 2016.
PONCE, Fernando; FUKUSHIMA, André Rinaldi. Aspectos farmacológicos e toxicológicos da cetamina: uma revisão de literatura. Brazilian Journal of Forensic Sciences, Medical Law and Bioethics, v. 6, n. 2, p. 210-227, 2017.
PORTER, Steven B. et al. Perioperative ketamine for acute postoperative analgesia: The Mayo Clinic—Florida experience. Journal of PeriAnesthesia Nursing, v. 30, n. 3, p. 189-195, 2015.
RADVANSKY, Brian M. et al. Role of ketamine in acute postoperative pain management: a narrative review. BioMed research international, v. 2015, 2015.
RAGAZZONI, Luca et al. Intra-operative low-dose ketamine does not reduce the cost of post-operative pain management after surgery: a randomized controlled trial in a low-income country. African health sciences, v. 19, n. 4, p. 3127-3135, 2019.
ROFAEL, Hany Z.; ABDEL‐RAHMAN, Mohamed S. Development and validation of a high‐performance liquid chromatography method for the determination of cocaine, its metabolites and ketamine. Journal of Applied Toxicology: An International Journal, v. 22, n. 2, p. 123-128, 2002.
ROTHER, Edna Terezinha. Revisão sistemática X revisão narrativa. Acta paulista de enfermagem, v. 20, n. 2, p. v-vi, 2007.
SANDBERG, Mårten et al. Ketamine for the treatment of prehospital acute pain: a systematic review of benefit and harm. BMJ open, v. 10, n. 11, p. e038134, 2020.
SIH, Kendra et al. Ketamine in adult emergency medicine: controversies and recent advances. Annals of Pharmacotherapy, v. 45, n. 12, p. 1525-1534, 2011.
SILVA, Francisca Charliane Carlos et al. Ketamina, da anestesia ao uso abusivo. Revista Neurociências, v. 18, n. 2, p. 227-237, 2010.
SIN, Billy et al. The use of ketamine for acute treatment of pain: a randomized, double-blind, placebo-controlled trial. The Journal of emergency medicine, v. 52, n. 5, p. 601-608, 2017.
SIN, Billy; TERNAS, Theologia; MOTOV, Sergey M. The use of subdissociative‐dose ketamine for acute pain in the emergency department. Academic Emergency Medicine, v. 22, n. 3, p. 251-257, 2015.
SOBIERAJ, Diana M. et al. Comparative effectiveness of analgesics to reduce acute pain in the prehospital setting. Prehospital Emergency Care, v. 24, n. 2, p. 163-174, 2020.
SOUZA, Marcela Tavares de; SILVA, MICHELLY Dias da; CARVALHO, Rachel de. Revisão integrativa: o que é e como fazer. Einstein, v. 8, n. 1, p. 102-106, 2010.
TAKIEDDINE, Sheila C. et al. Ketamine versus hydromorphone patient-controlled analgesia for acute pain in trauma patients. Journal of surgical research, v. 225, p. 6-14, 2018.
WOLFF, Kim; WINSTOCK, Adam R. Ketamine. CNS drugs, v. 20, n. 3, p. 199-218, 2006
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2023 Luã Leocovick, Amanda Battu Bubans, Laércio Bernardes, Lilian Caroline Bohnen, Mayra Zancanaro
