Ketamine Use for Successful Resolution of Post-ERCP Acute Pancreatitis Abdominal Pain

Agerwala, Suneel M.; Sundarapandiyan, Divya; Weber, Garret

doi:10.1155/2017/7845358

Cited by 3 publications

(3 citation statements)

References 13 publications

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“… 18 However, no RCTs have examined ketamine use in this context. Other acute pain conditions outside the perioperative setting in which ketamine has anecdotally been reported to be effective include postendoscopic retrograde cholangiopancreatography pancreatitis pain, 23 renal colic, 24 and exacerbation of central pain from Ehlers-Danlos syndrome. 25 …”

Section: Discussionmentioning

confidence: 99%

Consensus Guidelines on the Use of Intravenous Ketamine Infusions for Acute Pain Management From the American Society of Regional Anesthesia and Pain Medicine, the American Academy of Pain Medicine, and the American Society of Anesthesiologists

Schwenk

Viscusi

Buvanendran

et al. 2018

Regional Anesthesia and Pain Medicine

278

221

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BackgroundKetamine infusions have been used for decades to treat acute pain, but a recent surge in usage has made the infusions a mainstay of treatment in emergency departments, in the perioperative period in individuals with refractory pain, and in opioid-tolerant patients. The widespread variability in patient selection, treatment parameters, and monitoring indicates a need for the creation of consensus guidelines.MethodsThe development of acute pain ketamine guidelines grew as a corollary from the genesis of chronic pain ketamine guidelines. The charge for the development of acute pain ketamine guidelines was provided by the Boards of Directors of both the American Society of Regional Anesthesia and Pain Medicine and the American Academy of Pain Medicine, who approved the document along with the American Society of Anesthesiologists' Committees on Pain Medicine and Standards and Practice Parameters. The committee chair developed questions based on input from the committee during conference calls, which the committee then refined. Groups of 3 to 5 panel members and the committee chair were responsible for answering individual questions. After preliminary consensus was achieved, the entire committee made further revisions via e-mail and conference calls.ResultsConsensus guidelines were prepared in the following areas: indications, contraindications for acute pain and whether they differ from those for chronic pain, the evidence for the use of ketamine as an adjunct to opioid-based therapy, the evidence supporting patient-controlled ketamine analgesia, the use of nonparenteral forms of ketamine, and the subanesthetic dosage range and whether the evidence supports those dosages for acute pain. The group was able to reach consensus on the answers to all questions.ConclusionsEvidence supports the use of ketamine for acute pain in a variety of contexts, including as a stand-alone treatment, as an adjunct to opioids, and, to a lesser extent, as an intranasal formulation. Contraindications for acute pain are similar to those for chronic pain, partly based on the observation that the dosage ranges are similar. Larger studies evaluating different acute pain conditions are needed to enhance patient selection, determine the effectiveness of nonparenteral ketamine alternatives, define optimal treatment parameters, and develop protocols optimizing safety and access to care.

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Section: Discussionmentioning

confidence: 99%

Consensus Guidelines on the Use of Intravenous Ketamine Infusions for Acute Pain Management From the American Society of Regional Anesthesia and Pain Medicine, the American Academy of Pain Medicine, and the American Society of Anesthesiologists

Schwenk

Viscusi

Buvanendran

et al. 2018

Regional Anesthesia and Pain Medicine

278

221

View full text Add to dashboard Cite

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“…In a case report of a teenager with severe pain secondary to necrotizing pancreatitis, Mulder et al found that the initiation of ketamine as adjunctive pain management led to a rapid reduction in pain scores by day five of infusion [159]. In another case report of a patient with severe post-ERCP pain secondary to acute pancreatitis, Agerwala et al found that the initiation of ketamine infusion was effective in producing quick and long-lasting analgesia [160].…”

Section: Ketaminementioning

confidence: 99%

Comprehensive Review of Acute Pancreatitis Pain Syndrome

Beiriger

Khan

Yan

et al. 2023

Gastrointestinal Disorders

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Pancreatitis is a condition that causes inflammation in the pancreas, an organ located behind the stomach. This condition often presents as neuropathic, inflammatory, and/or visceral pain. Acute pancreatitis is typically characterized by sudden and severe abdominal pain, often in the upper right part of the abdomen. The pain from pancreatitis can be caused by different mechanisms, such as abnormal activation of pancreatic zymogens or NF-κB mediated inflammation in the pancreas. The treatment of pancreatitis depends on its type, severity, and underlying cause. Hospitalization and medications are typically necessary, while in others, surgery may be required. Proper management of pancreatitis is essential, as it can help reduce the risk of complications and improve the patient’s quality of life. The literature on pancreatitis pain management evaluates systematic approaches and the effectiveness of various treatments, such as lidocaine, opioid agonists, ketamine, magnesium, endoscopic methods, spinal cord stimulation, and other novel treatments present opportunities for exploration in pancreatitis pain management.

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“…There are anatomic and clinical indicators of neuropathic pain in patients with chronic pancreatic pain, including pancreatic neuritis, pancreatic neural hypertrophy and hyperplasia, as well as hyperalgesia and allodynia (1). Pediatric neuropathic pain can be successfully treated using N‐methyl‐D‐aspartate (NMDA)‐receptor antagonist medications, such as ketamine (3) and methadone (4), and accordingly, emerging evidence from adults with acute and chronic pancreatic pain can demonstrate a favorable response to ketamine (5,6).…”

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confidence: 99%