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
DOI:
https://doi.org/10.14295/idonline.v13i44.1593Palavras-chave:
Cetamina, Droga analgésica, Dor crônicaResumo
A cetamina é uma droga antagonista que não compete com os receptores NMDA, o que a torna capaz de ser usada para fins sedativos e analgésicos, a depender do caso. Trata-se de uma droga que já vem sendo utilizada para o tratamento da dor crônica há muito tempo, apesar das poucas pesquisas formais a esse respeito. Este estudo discute o uso da cetamina no tratamento da dor aguda/crônica em seres humanos. Os resultados levaram a crer que o uso de cetamina no tratamento da dor, é eficaz em diversos casos, inclusive para os quadros de dor crônica, embora seja necessário observar-se as contra-indicações e os efeitos colaterais inerentes ao uso dessa droga. Outros estudos demonstraram ser viável apenas como medida temporária. Para uso por tempo prolongado, outras opções devem ser consideradas.
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AMBROSE C., SALE S., HOWELLS R. ET AL. Intravenous clonidine infusion in critically ill children: dose dependent sedative effects and cardiovascular stability. BJA, 2000;84:794-796.
AZEVEDO V. M., LAURETTI G. R., PEREIRA N. L., REIS M. P. Transdermal ketamine as an adjuvant for postoperative analgesia after abdominal gynaecological surgery using lidocaine epidural blockade. Anesth Analg 2000; 91: 1479–82.
BACKONJA M., ARNDT G., GOMBAR K. A., ET AL. Response of chronic neuropathic pain syndromes to ketamine: a preliminary study. Pain, 1994; 56: 51–7.
BROADLEY K. E., KUROWSKA A., TOOKMAN A. Ketamine injection used orally. Palliat Med 1996; 10: 247–50.
CLEMENTS J. A., NIMMO W. S., GRANT I. S. Bioavailability, pharmacokinetics and analgesic activity of ketamine in humans. J Pharm Sci 1982; 71: 539–42.
CORSSEN G., REVES J. G., STANLEY T. H. Dissociative Anesthesia, em: Corssen G - Intravenous Anesthesia and Analgesia. Philadelphia: Lea and Febiger, 1988;99.
DOENICKE A., KUGLER J., MAYER M. ET AL. Ketamine racemate or S(+)-ketamine and midazolam. The effect on vigilance, efficacy and subjective findings. Anaesthesist, 1992;41:610-618
DOMINO E. F., CHODOFF P., CORSSEN G. Pharmacologic effects of CI-581, a new dissociative anesthetic in man. Clin Pharmacol Ther. 1965;6:279-291.
EIDE P. K., STUBHAUG A., STENEHJEM A. E. A dor da disestesia central após lesão medular traumática depende da ativação do receptor N- metil-d-aspartato. Neurocirurgia, 1995; 37: 1080-7.
ENARSON M. C., HAYS H., WOODROFFE M. A. Clinical experience with oral ketamine. J Pain Symptom Manage, 1999; 17: 384–6.
FLOHR, H. Sensations and brain processes. Behav Brain Res, 1995; 71: 157–61.
FISHER K., CODERRE T. J., HAGEN N. A. Targeting the N-methyl-D-aspartate receptor for chronic pain mangement. Preclinical animal studies, recent clinical experience and future research directions. J Pain Symptom Manage, 2000;20:358-373
FISHER K., HAGEN N. A. Analgesic effect of oral ketamine in chronic neuropathic pain of spinal origin: a case report. J Pain Symptom Manage, 1999; 18: 61–6.
FRANKS J. F., OLESEN A. S., MIKKELSEN S. S., BORGBJERG F. M. Ketamine in the management of intractable phantom pain. Ugeskr Laeger, 1995; 157: 3481–2.
GRANT I. S., NIMMO W. S., CLEMENTS J. A. Pharmacokinetics and analgesic effect of i. m. and oral ketamine. Br J Anaesth 1981; 53: 805–10.
GRAVEN-NIELSEN T., ASPEGREN KENDALL S., HENRIKSSON K. G., ET AL. A cetamina reduz a dor muscular, a soma temporal e a dor referida em pacientes com fibromialgia. Pain, 2000; 85: 483-91.
GÜNDÜZ M., SAKALLI S., GÜNEŞ Y. ET AL. Comparison of effects of ketamine, ketamine-dexmedetomidine, and ketaminemidazolam on dressing changes of burn patients. J Anaesthesiol Clin Pharmacol. 2011;27(2):220-224.
HAINES D. R., GAINES S. P. N of 1 randomised controlled trials of oral ketamine in patients with chronic pain. Pain, 1999; 83: 283–7.
HATANO S., KEANE D. M., BOGGS R. E. ET AL. Diazepam-ketamine anaesthesia for open heart surgery a “micro-mini” drip administration technique. Can J Anesth, 1976;23:648-656.
HIROTA K., LAMBERT D. G. Ketamine: its mechanism(s) of action and unusual clinical uses. Br J Anaesth, 1996;77:441-444
HOFFMANN V., COPPEJANS H., VERCAUTEREN M., ADRIAENSEN H. Successful treatment of postherpetic neuralgia with oral ketamine. Clin J Pain, 1994; 10: 240–2.
HUSTVEIT O., MAURSET A., OYE I. Interaction of the chiral forms of ketamine with opioid, phencyclidine, sigma and muscarinic receptors. Pharmacol Toxicol, 1995;77:355-359
JAKSCH W., LANG S., REICHHALTER R. ET AL. Perioperative small-dose S(+)-ketamine has no incremental beneficial effects on postoperative pain when standard-practice opioid infusions are used. Anesth Analg, 2002;94:981-986.
KINGSTON H. G., BRETHERTON K. W., HOLLOWAY A. M. A comparison between ketamine and diazepam as induction agents for pericardectomy. Anesth Intensive Care, 1978;6:66-70.
KORTTILA K., LEVANEN J. Untoward effects of ketamine combined with diazepam for supplementing conduction anaesthesia in young and middle-aged adults. Acta Anaesthesiol Scand, 1978;22:640-648.
KOINIG H., MARHOFER P. S(+)-ketamine in paediatric anaesthesia. Paediatr Anaesth, 2003;13:185-187
LILBURN J., DUNDEE J., NAIR S. ET AL. Ketamine sequalae evaluation of the ability of various premedicants to attenuate its psychic actions. Anaesthesia, 1978;33:307-311.
LIN T. C., WONG C. S., CHEN F. C., ET AL. Cetamina, morfina e bupivacaína peridural de longa duração atenuam a nevralgia da distrofia simpática reflexa. Pode J Anaesth 1998; 45: 175–7.
LYONS B., CASEY W., DOHERTY P. ET AL. Pain relief with low-dose intravenous clonidine in a child with severe burns. Intens Care Med, 1996;22:249-251.
MACPHERSON R. D., WOODS D., PENFOLD J. Keta mine and midazolam delivered by patient-con trolled analgesia in relieving pain associated with burns dressings. Clin J Pain, 2008;24(7)568- 571.
MARIETTA M. P., WAY W. L., CASTAGNOLE JR N. ET AL. On the pharmacology of the ketamine enantiomorphs in the rat. J Pharmacol Exp Ther, 1977;202:157-165.
MATHISEN L. C., SKJELBRED P., SKOGLUND L. A., OYE I. Effect of ketamine, an NMDA receptor inhibitor, in acute and chronic orofacial pain. Pain 1995; 61: 215–20.
NIKOLAJSEN L., HANSEN C. L., NIELSEN J., ET AL. The effect of ketamine on phantom pain: a central neuropathic disorder maintained by peripheral input. Pain 1996; 67: 69–77.
NIKOLAJSEN L., HANSEN P. O., JENSEN T. S. Oral ketamine in the treatment of postamputation stump pain. Acta Anaesthesiol Scand 1997; 41: 427–9.
PEDERSEN J. L., GALLE T. S., KEHLET H. Peripheral analgesic effects of ketamine in acute inflammatory pain. Anesthesiology 1998; 89: 58–66.
PERSSON J., HASSELSTROM J., WIKLUND B., ET AL. The analgesic effect of racemic ketamine in patients with chronic ischaemic pain due to lower extremity arteriosclerosis obliterans. Acta Anaesthesiol Scand 1998; 42: 750–8
RAEDER JC, STENSETH LB. Ketamine: a new look at an old drug. Curr Opin Anaesthesiol, 2000;13:463-468.
SCHELLER M., BUFLER J., HERTLE I., ET AL. Ketamine blocks currents through mammalian nicotinic acetylcholine receptor channels by interaction with both the open and the closed state. Anesth Analg, 1996;83:830-836.
SMITH D. J., AZZARO A. J., SALDIVAR S. B. Properties of the optical isomers and metabolites of ketamine on the high affinity transport and catabolism of monoamines. Neuropharmacology, 1981;20:391-396.
SORENSEN J., BENGTSSON A., BACKMAN E., ET AL. Análise da dor em pacientes com fibromialgia. Scand J Rheumatol 1995; 24: 360-5.
STANNARD CF, PORTER GE. Ketamine hydrochloride in the treatment of phantom limb pain. Pain 1993; 54: 227–30.
TAKAHASHI H., MIYAZAKI M., NANBU T., ET AL. O antagonista do receptor de NMDA, ketamina, elimina a dor neuropática após administração epidural em um caso clínico. Pain 1998; 75: 391-4.
TOSUN Z., ESMAOGLU A., CORUH A. Propofol-ketamine vs propofolfentanyl combinations for deep sedation and analgesia in pediatric patients undergoing burn dressing changes. Pediatr Anesth, 2008;18:43-47.
TURHANOGLU S., KARARMAZ A., ÖZYILMAZ M. A., ET AL. Effects of different doses of oral ketamine for premedication of children. Eur J Anaesthesiol, 2003;20:56-60.
VAN DER LINDEN P., GILBART E., ENGELMAN E. Comparison of halothane, isoflurane, alfentanil, and ketamine in experimental septic shock. Anesth Analg, 1990;70:608-617.
VISSER E., SCHUG S. The role of ketamine in pain management. Biomed Pharmacother, 2006;60:341-348.
WALKER S. M., COUSINS M. J. Reduction in hyperalgesia and intrathecal morphine requirements by low-dose ketamine infusion. J Pain Symptom Manage, 1997; 14: 129–32.
WHITE P. F., WAY W. L., TREVOR A. J. Ketamine - its pharmacology and therapeutic uses. Anesthesiology, 1982;56:119-136
WOLFE R. R., LOEHR J. P., SCHAFFER M. S. Hemodynamic effects of ketamine, hypoxia and hyperoxia in children with surgically treated congenital heart disease residing greater than or equal to 1,200 meters above sea level. Am J Cardiol, 1991;67:84-87.
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