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See Latest ArticlesOpioid Switching and Burst Ketamine to Improve the Opioid Response in Patients With Movement-related Pain Due to Bone Metastases
The Clinical Journal of Pain, 08/21/09
Mercadante S et al. – The development of breakthrough pain due to movement (incident pain), associated with bone metastases is so rapid that no medication as needed has such a short onset to parallel this temporal pattern of pain firing. Experimental studies have shown that bone metastases are characterized by a specific pattern of spinal hyperexcitation requiring higher doses of opioids. Optimization of basal opioid regimen may improve mobilization. However, adverse effects may more likely occur. The role of opioid switching and burst ketamine to further improve the opioid response has never been assessed in this context. Further studies in animals could confirm these preliminary data, with specific design to parallel this clinical context.
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