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Evaluation of oral cetamin for the treatment of neuropathic pain

Abstract:

Background and objectives: Neuropathic pain is caused by lesion or disfunction of peripheric or central nervous system. NMDA receptors antagonists as ketamine are used for pain treatment(1). Nevertheless there are controversies about the efficacy of these drugs in reduce the dose of antidepressants and anticonvulsants. The aim of his study was to evaluate the efficacy of ketamine for neuropathic pain. Methods: Thirty patients with neuropathic pain were included in randomized double-blind study of two groups. G 1 patients (N = 15) received 25 mg of amitriptiline plus 600 mg of carbamazepine associated with 10 mg/8 h of S(+) ketamine; G 2 (N =15) received 25mg of amitriptiline plus 600 mg of carbamazepine. Analgesic complementation was done with 30mg of codein. Pain was assessed by numeric scale, weekly during 4 weeks. Results: Twenty two patients completed the study (10 in G1 and 13 in G2). There was need for complementation in 5 patients in G1 and 1 patient in G2. Pain relief was greater in G1 (T0 = 7.3±1.76 x 6.95±1.81; T7= 4.7±2.8 x 6.75±1.71; T 14= 3.7±2.75 x 5.16±1.8; T21= 3.9±2.72 x 5.16±2.88; T28= 2.6±2.17 x 4.66±2.74), but without statistic difference; Mann Whitney test. More frequent side effects were: somnolence, xerostomy, dizziness, taquicardia, epigastric pain, and constipation. Conclusions: There was not statistic difference in pain relief with oral S(+)ketamine associated with amitriptiline and carbamazepine. © Copyright Moreira Jr. Editora.