Evidence map›Paper›PMID 34233070›Full record

ArticlePain practice : the official journal of World Institute of Pain2021

Effect of intravenous low-dose S-ketamine on pain in patients with Complex Regional Pain Syndrome: A retrospective cohort study.

Thomas J P Mangnus, Maaike Dirckx, Krishna D Bharwani, Cecile C de Vos, Sander P G Frankema, Dirk L Stronks, Frank J P M Huygen

Registry-linked trialOpen access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Pain practice : the official journal of World Institute of Pain, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05212571 (Long-term Pain Modulation by Intravenous Esketamine in Complex Regional Pain Syndrome), which is not on this map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
3.2field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05212571 naenrolling by invitationnot on this mapstarted 2022, after this paper: background citation

Long-term Pain Modulation by Intravenous Esketamine in Complex Regional Pain Syndrome: a Non-inferiority Study

TypeinterventionalSponsorErasmus Medical CenterRan2022 to 2027Enrolled60ConditionsComplex Regional Pain Syndromes, CRPS (Complex Regional Pain Syndromes)ArmsS-ketamine infusion inpatient setting, S-ketamine infusion outpatient setting
3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 17 citations in OpenAlex.

  1. Review
  2. Article
  3. Review
  4. Article
  5. Esketamine Anesthetizes Mice With a Similar Potency to Racemic Ketamine.Dose-response : a publication of International Hormesis Society
    Article
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Thomas J P MangnusCenter for Pain Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands.ORCID https://orcid.org/0000-0001-8302-6991
Maaike DirckxCenter for Pain Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
Krishna D BharwaniCenter for Pain Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
Cecile C de VosCenter for Pain Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
Sander P G FrankemaCenter for Pain Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
Dirk L StronksCenter for Pain Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
Frank J P M HuygenCenter for Pain Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
Erasmus MC · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe objective of this study was to assess the effectiveness of a low-dose intravenous S-ketamine treatment on refractory pain in patients with Complex Regional Pain Syndrome (CRPS).

methodsIn this retrospective study, patients with CRPS who received intravenous S-ketamine from March 2010 to April 2019 were included. According to our inpatient protocol, S-ketamine dose was increased until pain reduction was achieved or side effects were observed. Maximum dose was 14 mg/h and treatment duration was 7 days. Primary outcome parameters were pain scores (Numeric Rating Scale) at baseline (T0), end of infusion (T1), and approximately 4 weeks postinfusion (T2). Patients were categorized as responder/nonresponder at T1 and T2. Patients were considered a responder in case there was pain score reduction of greater than or equal to 2 points or if treatment was reported as successful.

resultsForty-eight patients were included. Mean disease duration was 5 years (interquartile range [IQR] = 6 years). Median pain score significantly decreased from 8 (IQR = 2) at T0 to 6 (IQR = 4) at T1 (p < 0.001). At T1, 62% of the patients were responders. At T2, 48% of the patients remained a responder. A significant proportion of the responders at T1 turned into nonresponders at T2 (p = 0.03).

conclusionIn a group of patients with CRPS with refractory pain, low-dose intravenous S-ketamine treatment resulted in effective pain relief during infusion. Although a significant proportion of initial responders became nonresponders at follow-up, half of the patients were still a responder at ~ 4 weeks postinfusion. Further research is needed to investigate mechanisms responsible for pain relief by S-ketamine infusions and to ascertain possible predictors of response to the treatment.

Indexed as

Complex Regional Pain SyndromesIntractable PainAnalgesicsHumansInfusions, IntravenousKetamineRetrospective StudiesTreatment OutcomeAnalgesicsEsketamineKetamineComplex Regional Pain Syndrome (CRPS)doseintravenouspainS-ketamine

Identifiers

PMID34233070
PMCPMC9291497
OpenAlexW3178323666

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.