School of Medicine and Health Sciences Poster Presentations

Title

The Effect of Increased Total Daily Dose of Outpatient Ketamine Infusions on Outcomes in Chronic Neuropathic Pain Patients

Poster Number

175

Document Type

Poster

Publication Date

3-2016

Abstract

Introduction: Ketamine infusions have shown to provide significant relief in patients with chronic neuropathic pain. At our institution, patients have demonstrated improvement in mood and ambulation after treatment with four-hour outpatient ketamine infusions at subanesthetic doses. In this study, we compared four and five-hour infusions in the same patient to determine if a longer duration of infusion or a higher daily ketamine dose improved quality of life (QOL) outcomes.

Method: With IRB approval, we examined QOL outcome measurements in patients who received three consecutive days of four-hour ketamine infusions followed by three days of five-hour infusions months later. Ketamine doses did not exceed 1mg/kg/hr. Patients completed a Brief Pain Inventory assessing the impact of their chronic pain on QOL before each infusion session and again several weeks later. Four predictors (age, sex, race, and pre-treatment score) were used to evaluate any change in QOL due to demographics. To compare scores between four and five-hour infusion sessions, a paired t-test and multivariate generalized estimating equations were used.

Results: Ten patients underwent four and five-hour ketamine infusions. There was no significant difference in QOL outcome measurements between the infusion sessions. The mean pain score did not show statistical significance when duration of infusion was increased.

Conclusions: Although patients infused with subanesthetic doses of ketamine over five hours reported improvement in level of pain, activity, mood, work, relationships and sleep, these results were not statistically significant. We will further evaluate the impact of dose and duration of infusion with a larger patient population.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Open Access

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Comments

Presented at: GW Research Days 2016

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The Effect of Increased Total Daily Dose of Outpatient Ketamine Infusions on Outcomes in Chronic Neuropathic Pain Patients

Introduction: Ketamine infusions have shown to provide significant relief in patients with chronic neuropathic pain. At our institution, patients have demonstrated improvement in mood and ambulation after treatment with four-hour outpatient ketamine infusions at subanesthetic doses. In this study, we compared four and five-hour infusions in the same patient to determine if a longer duration of infusion or a higher daily ketamine dose improved quality of life (QOL) outcomes.

Method: With IRB approval, we examined QOL outcome measurements in patients who received three consecutive days of four-hour ketamine infusions followed by three days of five-hour infusions months later. Ketamine doses did not exceed 1mg/kg/hr. Patients completed a Brief Pain Inventory assessing the impact of their chronic pain on QOL before each infusion session and again several weeks later. Four predictors (age, sex, race, and pre-treatment score) were used to evaluate any change in QOL due to demographics. To compare scores between four and five-hour infusion sessions, a paired t-test and multivariate generalized estimating equations were used.

Results: Ten patients underwent four and five-hour ketamine infusions. There was no significant difference in QOL outcome measurements between the infusion sessions. The mean pain score did not show statistical significance when duration of infusion was increased.

Conclusions: Although patients infused with subanesthetic doses of ketamine over five hours reported improvement in level of pain, activity, mood, work, relationships and sleep, these results were not statistically significant. We will further evaluate the impact of dose and duration of infusion with a larger patient population.