Such interventions would have the potential to reduce the prevalence of chronic pain in the population .
Although certain risk factors can identify individuals who are most likely to develop chronic pain , few interventions to prevent chronic pain have been identified .
To facilitate the identification of preventive interventions , an IMMPACT meeting was convened to discuss research design considerations for clinical trials investigating the prevention of chronic pain .
We present general design considerations for prevention trials in population s that are at relatively high risk for developing chronic pain .
Perioperative Intravenous Ketamine Infusion for the Prevention of Persistent Post-amputation Pain: A Randomized, Controlled Trial
We hypothesized that perioperative ketamine administration would modify acute central sensitization following amputation and hence reduce the incidence and severity of persistent post-amputation pain ( both phantom limb and stump pain ) . In a r and omized , controlled trial , 45 patients undergoing above- or below-knee amputation received ketamine 0.5 mg.kg–1 or placebo as a pre-induction bolus followed by an intravenous infusion of ketamine 0.15 mg.kg–1.h–1 or normal saline for 72 hours postoperatively . Both groups received st and ardized general anaesthesia followed by patient-controlled intravenous morphine . The surface area of allodynia over the stump was mapped at days 3 and 6 . Postamputation pain was assessed at days 3 and 6 and at 6 months postoperatively . We found no significant difference between groups in the surface area of stump allodynia or in morphine consumption . There was an unexplained , but significant , increase in the incidence of stump pain in the ketamine group at day 3 . At six-month review , the incidence of phantom pain was 47 % in the ketamine group and 71 % in the control group . This did not reach statistical significance ( P=0.28 ) as the power of the study was based on the search for a large treatment effect . The incidence of stump pain at six months was 47 % in the ketamine group and 35 % in the control group ( P=0.72 ) . There were no significant between-group differences in pain severity throughout the study period . Ketamine at the dose administered did not significantly reduce acute central sensitization or the incidence and severity of post-amputation pain
Such interventions would have the potential to reduce the prevalence of chronic pain in the population .
Although certain risk factors can identify individuals who are most likely to develop chronic pain , few interventions to prevent chronic pain have been identified .
To facilitate the identification of preventive interventions , an IMMPACT meeting was convened to discuss research design considerations for clinical trials investigating the prevention of chronic pain .
We present general design considerations for prevention trials in population s that are at relatively high risk for developing chronic pain .