Journal of Rare Cardiovascular Diseases
ISSN: 2299-3711 (Print)
e-ISSN: 2300-5505 (Online)
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Comparison of Ketamine Infusion Versus Conventional Therapy in Chronic Neuropathic Pain: A Prospective Randomized Controlled Study
Dr.Pavithra C
Dr.Malavika Kalamdani
Dr.Sindhu. A.P
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1
Assistant professor Department of Anaesthesiology ESIC MC & PGIMSR, Rajajinagar, Bangalore 560010
2
Assistant professor Department of anaesthesiology ESIC MC PGIMSR Rajajinagar Bangalore 560010.
3
Junior consultant Anaesthesiology Vasavi hospital.
Received: 2025-01-13
Revised: 2025-01-21
Accepted: 2025-02-18
Published: 2025-03-11
Full Text
Abstract
- Background Chronic neuropathic pain is a persistent and debilitating condition arising from dysfunction of the somatosensory nervous system. Despite optimized conventional therapy using anticonvulsants, antidepressants, and opioids, many patients experience inadequate pain relief or adverse drug reactions. Intravenous ketamine, an NMDA receptor antagonist, has been proposed as an effective option for refractory neuropathic pain due to its action on central sensitization mechanisms. Aim: To compare the efficacy and safety of intravenous ketamine infusion versus conventional pharmacotherapy in patients with chronic neuropathic pain. Methods: A prospective randomized controlled study was onducted over 12 months in a tertiary care pain clinic.Sixty patients with chronic neuropathic pain (VAS ≥5 for >3 months) were randomized into two groups: Group K (ketamine infusion 0.3–0.5 mg/kg/hr for 4–6 hours under monitoring) and Group C (optimized conventional therapy including pregabalin/duloxetine/amitriptyline ± opioids). Pain intensity (VAS), opioid consumption, quality of life scores, and adverse effects were assessed at baseline, 1 week, 1 month, and 3 months. Continuous variables were analyzed using independent -test and repeated measures ANOVA; categorical variables were compared using Chi-square test. A p-value <0.05 was considered statistically significant. Results: The ketamine group demonstrated significantly greater reduction in pain scores compared to the conventional therapy group at 1 week (VAS reduction: 4.1 ± 1.2 vs 2.3 ± 1.1, p<0.001) and 1 month (3.5 ± 1.4 vs 1.9 ± 1.3, p=0.002). Sustained analgesic benefit at 3 months was observed in 53.3% of ketamine patients compared to 26.7% in the conventional group (p=0.03). Mean opioid consumption decreased significantly in the ketamine group (−38%) compared to the conventional group (−12%, p<0.001). Quality of life scores improved significantly in the ketamine arm (p=0.01). Transient adverse effects such as dizziness and mild psychomimetic symptoms were noted in 23.3% of ketamine patients but were self-limiting. Conclusion: Intravenous ketamine infusion provided superior short-term analgesia, significant opioid-sparing effect, and improved functional outcomes compared to conventional therapy in chronic neuropathic pain, with manageable adverse effects. Ketamine may be considered an effective option in treatment-resistant cases
Keywords
Chronic neuropathic pain, Ketamine infusion, NMDA receptor antagonist, Opioid-sparingeffect, Randomized controlled study, Quality of life
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Classification of Rare Cardiovascular Diseases
anticoagulation
atrial fibrillation
atrial septal defect
cardiomyopathy
computed tomography
congenital heart disease
echocardiography
electrocardiogram
electrocardiography
heart failure
implantable cardioverter‑defibrillator
magnetic resonance imaging
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rare cardiovascular disease
rare disease
right heart catheterization
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