Topical ketamine in the treatment of mucositis pain.
Ketamine oral rinse provided effective palliation of intractable mucositis pain in a 32-year-old woman with squamous carcinoma of the tongue undergoing radiation therapy. Pain at rest and with eating decreased with ketamine, allowing for a tapering of her opiate dose. No side effects of ketamine were reported. Treatment benefits most likely arose from the inhibition by ketamine of peripheral N-methyl D-aspartate receptors, though other mechanisms of action may have been contributory. Further evaluation of topical ketamine in the treatment of mucositis-related pain, and, potentially, other causes of inflammatory oral pain, are warranted.
Slatkin
Neal E
NE
Department of Supportive Care, Pain and Palliative Medicine, City of Hope National Medical Center, Duarte, California 91010, USA. Supportive_care@coh.org
Rhiner
Michelle
M
D000328:Adult; D000700:Analgesics / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000503:physiopathology*; D018691:Excitatory Amino Acid Antagonists / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007649:Ketamine / Q000627:therapeutic use*; D009092:Mucous Membrane / Q000528:radiation effects; D010148:Intractable Pain / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D010166:Palliative Care; D016194:Receptors, N-Methyl-D-Aspartate / Q000037:antagonists & inhibitors; D014062:Tongue Neoplasms / Q000150:complications / Q000503:physiopathology*
D000700:Analgesics; D018691:Excitatory Amino Acid Antagonists; D016194:Receptors, N-Methyl-D-Aspartate; D007649:Ketamine