Faculty Collaboration Database

Treatment of severe mucositis pain with oral ketamine mouthwash. Support Care Cancer 2017 Jul;25(7):2215-2219

Date

02/13/2017

Pubmed ID

28190158

Pubmed Central ID

PMC5500907

DOI

10.1007/s00520-017-3627-6

Scopus ID

2-s2.0-85012134699 (requires institutional sign-in at Scopus site)   20 Citations

Abstract

PURPOSE: Mucositis is a significant complication of intensive chemotherapy or hematopoietic cell transplantation (HCT), with few treatment options. Ketamine mouthwashes have been used for pain relief, but supporting evidence is limited. The primary objective of this study was to assess the reduction in pain intensity of stomatodynia and odynophagia compared to baseline assessment.

METHODS: This open-label, prospective, phase II interventional study (NCT01566448) was conducted from February 2012 through July 2015. Patients with grade 3 or 4 oral mucositis according to the World Health Organization (WHO) scale as a result of chemotherapy were treated with ketamine mouthwash 20 mg/5 mL four times daily and every 4 h as needed.

RESULTS: Thirty patients were enrolled and a total of 136 assessments were conducted. A statistically significant reduction in pain scores of 2 and 3 points was achieved after 1 h and 3 days, respectively (p < 0.0001, p = 0.0003). Pain scores were significantly improved while swallowing, reduced 1 and 4 points at 1-h and 3-day assessment, respectively (p = 0.0006, p = 0.0001). No patients developed adverse effects related to ketamine administration.

CONCLUSION: Ketamine mouthwashes resulted in clinically meaningful and statistically significant reduction in pain scores, have an acceptable safety profile, and can be a useful adjunctive treatment in the multi-modal management of severe mucositis.

Author List

Shillingburg A, Kanate AS, Hamadani M, Wen S, Craig M, Cumpston A

Author

Mehdi H. Hamadani MD Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Female
Hematopoietic Stem Cell Transplantation
Humans
Ketamine
Male
Middle Aged
Mouthwashes
Mucositis
Pain
Prospective Studies
Stomatitis
Young Adult