Korean J Hosp Palliat Care.  2016 Sep;19(3):249-255. 10.14475/kjhpc.2016.19.3.249.

Factors Associated with Ketamine Use in Pancreatic Cancer Patient in a Single Hospice Center

• Kwon KM
• Lee YJ
• Choi CJ
• Kim CM
• Yoon JH
• Kim MH

• KMID: 2351388
• DOI: http://doi.org/10.14475/kjhpc.2016.19.3.249

Abstract

PURPOSE
Up to 90% of pancreatic cancer patients suffer from neuropathic pain. In a palliative care setting, pain control in pancreatic cancer patient is one of the major goals. Ketamine is a N-methyl-D-aspartate (NMDA) receptor antagonist, effective in neuropathic pain. Additionally, there have been studies about the opioid sparing effect of ketamine. This study was held in the palliative care unit among pancreatic cancer patients to determine the factors related to ketamine use and the opioid sparing effect.
METHODS
The medical records of pancreatic cancer patients admitted to St. Mary's hospital palliative care unit between January, 2013 and December, 2014 were reviewed. Patients were divided into 2 categories according to ketamine use. Also, opioid use before and after ketamine use was compared in the ketamine group.
RESULTS
Compared to the non-ketamine use group, patients in the ketamine group required a higher dose of opioid. The total opioid dose, daily opioid dose, number of daily rescue medications, and daily average rescue dose were statistically significantly higher in the ketamine group. The opioid requirement was increased after ketamine administration.
CONCLUSION
In this retrospective study, ketamine was frequently considered in patients with severe pain, requiring higher amount of opioid. Studies about palliative use of ketamine in a larger number of patients with diverse types of cancer pain are required in the future.

Keyword

Ketamine; Palliative care; Morphine; Cancer pain

MeSH Terms

Hospices*
Humans
Ketamine*
Medical Records
Morphine
N-Methylaspartate
Neuralgia
Palliative Care
Pancreatic Neoplasms*
Retrospective Studies
Ketamine
Morphine
N-Methylaspartate