Disclosures: Anand S. Patil, BS: No financial relationships or conflicts of interest

Objective: To conduct a systematic review on clinical studies using ketamine infusion for patients with treatment-resistant Complex Regional Pain Syndrome (CRPS).

Design: The systematic review was registered on PROSPERO (CRD42021228470). An electronic search of three databases (PubMed, CINAHL, and Cochrane Review) was conducted with the keywords “Ketamine” OR “Ketamine infusion” AND “CRPS” OR “Complex Regional Pain Syndrome”. A total of 101 papers resulted in the search. After implementation of inclusion and exclusion criteria by two reviewers, 14 papers were included in the review.Setting : Inclusion criteria consisted of randomized controlled trials or observational studies that studied the effect of the use of ketamine infusion on pain relief for patients with complex regional pain syndrome (CRPS). Exclusion criteria consisted of non peer-reviewed studies, systematic or meta analysis reviews, case reports, and animal studies.Participants : A total of 455 patients (ages 12 – 68) diagnosed with CRPS were observed in the included studies.

Interventions: Patients were administered ketamine infusions with doses ranging from 0.15 mg/kg to 7 mg/kg.

Main Outcome Measures: Pain scores were evaluated after infusion via visual analog scale (VAS) or verbal numeric rating scale (NRS).

Results: In this systematic review, 14 studies met the inclusion criteria and were included for review. Of the studies analyzed, the dosage of ketamine infusion ranged from 0.15 mg/kg to 7 mg/kg for treatment of Complex Regional Pain Syndrome (CRPS). In 13 of the studies, ketamine infusion resulted in a decrease in pain scores and relief of symptoms.Conclusions: Patients who received ketamine infusion for CRPS reported adequate pain relief with treatment. Given the results, this suggests that ketamine infusion may be a useful form of treatment for patients with no significant pain relief with other conservative measures. Future large scale studies, such as randomized double-blind placebo controlled trials, must be conducted to further assess the use of ketamine infusion for CRPS patients.

Level of Evidence: Level I

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/use-of-ketamine-infusions-for-treatment-of-complex-regional-pain-syndrome-a-systematic-review/