The NMDA-receptor antagonist ketamine abolishes neuropathic pain after epidural administration in a clinical case

被引：47

作者：

Takahashi, H ^{[1
]}

Miyazaki, M ^{[1
]}

Nanbu, T ^{[1
]}

Yanagida, H ^{[1
]}

Morita, S ^{[1
]}

机构：

[1] Teikyo Univ, Sch Med, Ichihara Hosp, Pain Ctr,Dept Anesthesiol, Chiba 29901, Japan

来源：

PAIN | 1998年 / 75卷 / 2-3期

关键词：

neuropathic pain; complex regional pain syndrome; n-methyl-d-aspartic acid receptor antagonist; ketamine; epidural administration;

D O I：

10.1016/S0304-3959(97)00189-9

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

A 14-year-old male patient developed severe right limb pain after traumatic sciatic nerve injury. His pain was diagnosed as neuropathic pain (complex regional pain syndrome, type II). He did not respond to any conventional therapy for limb pain including non-steroidal antiinflammatory drugs? antidepressants, anticonvulsants, continuous epidural administration of local anesthetics and psychotherapy. Following continuous epidural administration of a very low dose of ketamine, an N-methyl-D-aspartic acid (NMDA) receptor antagonist, 25 mu g/kg per h for 10 days. complete pain relief was obtained without any side-effects. There has been no recurrence of pain for 8 months after discontinuation of epidural ketamine. The symptoms related to dysfunction of the sympathetic nervous system still remained after complete pain relief. We discuss pain mechanisms, pain relief and the use of ketamine in this case. (C) 1998 International Association for the Study of Pain. Published by Elsevier Science B.V.

引用

页码：391 / 394

页数：4