Papers of the Week

Intranasal (IN) ketamine has been shown to be effective in controlling breakthrough chronic pain. However, there are no data evaluating IN ketamine for cancer-related pain. The objective of our study was to determine safety and pharmacology (pharmacokinetics and preliminary efficacy) of IN ketamine for uncontrolled cancer-related pain METHODS: This was a clinical trial of 10 adult patients with uncontrolled cancer-related pain. Each patient received escalating doses of ketamine over four visits, each 2-5 days apart: 10 mg IN at visit 1, 10 mg intravenous (IV) at visit 2, 30 mg IN at visit 3, and 50 mg IN at visit 4. Pain was measured before and after drug administration for up to 4 hours using the 11-point (0-10) Numerical Pain Rating Scale (NPRS).