Authors' objectives: To investigate whether there is any evidence on the efficacy and/or effectiveness of ketamine infusions (IV ketamine) in treating patients with widespread hyperalgesia and central sensitivity.

Authors' results and conclusions: Upon examination of the titles and abstracts of 157 studies resulting from our search, two studies were thought to be relevant and were retrieved in full for further appraisal. Of these two studies, one was in the form of abstract only while the other one was a full publication which presented the same data by the same authors. A full summary of that publication is outlined in our review. To summarize, although there seems to be some evidence from either low- or high-level but all of low-quality primary studies on the efficacy and/or effectiveness of IV ketamine in treating Complex Regional Pain Syndromes (CRPS) and chronic non-cancer pain (CNCP), the evidence needs to be interpreted with caution due to the fact that bias, chance and confounding cannot be excluded from affecting the reported outcomes. Further, these outcomes were mainly subjective in nature, were short-term and did not follow functional improvement while repeating infusions, while also potentially escalating adverse-effects. With regard to the role of IV ketamine in treating hyperalgesia, there was one high-level, low-quality exploratory study potentially showing very short-term effects in reducing pain, but this evidence is still exploratory in nature and needs to be replicated prior to its clinical application.

Authors' methods: A comprehensive and systematic literature search was conducted on commercial medical databases on November 1, 2022. A combination of keywords were employed in this search (for further details see the methods section of our review). No limitations, such as on the date or language of publication were implemented in any of these searches. Manual searches were also planned and conducted on the references of the articles that were retrieved in full text.

Project Status: Completed

URL for project: https://www.worksafebc.com/en/about-us/research-services/evidence-based-medicine-and-systematic-reviews

Year Published: 2022

URL for published report: https://www.worksafebc.com/resources/health-care-providers/guides/ketamine-infusion-therapy-hyperalgesia-centra-sensitivity-pain?lang=en

English language abstract: An English language summary is available

Publication Type: Mini HTA

Country: Canada

Organisation Name: WorkSafeBC

Contact Address: 6591 Westminster Highway, Richmond, BC, V7C 1C6 Canada. Tel: 604-231-8417; Fax: 604-279-7698

Contact Name: ebpg@worksafebc.com

Contact Email: ebpg@worksafebc.com

Copyright: WorkSafe BC