Usefulness of the perfusion index for monitoring the response to intravenous ketamine infusion therapy in patients with complex regional pain syndrome.

Background: This study was performed to compare the perfusion index (PI) between affected and unaffected limbs in patients with complex regional pain syndrome (CRPS); it also evaluated the usefulness of the PI for monitoring the response to intravenous ketamine infusion therapy in such patients. Met...

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Publicado en:Pain Practice Vol. 23; no. 5; pp. 535 - 543
Autores principales: Hong, Seung‐Wan, Hwang, Min‐Sik, Kim, Jae Hun, Kim, Minjung, Kim, Seong‐Hyop
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Jun2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jun2023
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1111/papr.13215
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        atl: Usefulness of the perfusion index for monitoring the response to intravenous ketamine infusion therapy in patients with complex regional pain syndrome.
      aug:
        au:
          Hong, Seung‐Wan
          Hwang, Min‐Sik
          Kim, Jae Hun
          Kim, Minjung
          Kim, Seong‐Hyop
        affil: Department of Anaesthesiology and Pain Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
      sug:
        subj:
          Complex Regional Pain Syndromes Drug Therapy
          Ketamine Administration and Dosage
          Infusions, Intravenous
          Treatment Outcomes Evaluation
          Extremities
          Perfusion Index Evaluation
          Predictive Value of Tests Evaluation
          Human
          Male
          Female
          Adolescence
          Adult
          Middle Age
          Pain Management
          Visual Analog Scaling
          ROC Curve
          Sensitivity and Specificity
          Descriptive Statistics
          Confidence Intervals
          Funding Source
          Adolescent: 13-18 years
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Male
          Female
      ab: Background: This study was performed to compare the perfusion index (PI) between affected and unaffected limbs in patients with complex regional pain syndrome (CRPS); it also evaluated the usefulness of the PI for monitoring the response to intravenous ketamine infusion therapy in such patients. Methods: In total, 46 patients with CRPS in one arm or leg were enrolled in this study. The PIs of the unaffected (PIControl) and affected (PICRPS) limbs were simultaneously evaluated before and after treatment. Results: PICRPS was significantly lower than PIControl at all time points. The change in PI from immediately before to 30 min after intravenous ketamine infusion therapy (TBefore and T30 min, respectively) in the affected limb was significantly correlated with the change in visual analog pain scale (VAS) between the two time points (r = 0.646, p < 0.001). The area under the curve for the changes in VAS and PICRPS between TBefore and T30 min was 0.928. The optimal threshold value for the change in PICRPS between TBefore and T30 min, to distinguish responders with a ≥ 50‐point reduction in VAS score from nonresponders, was 22.60% with a sensitivity of 0.811 (95% CI: 0.774–0.848) and a specificity of 0.889 (95% CI: 0.848–0.930). Thirty‐one patients showed a ≥ 50‐point reduction in VAS score [67% (95% CI: 54%–80%)] and 15 patients showed a < 50‐point reduction in VAS score [33% (95% CI: 20%–46%)]. Thirty patients showed an increased PI ≥ 22.60% [65% (95% CI: 50%–78%)] and 16 patients showed an increased PI < 22.60% [35% (95% CI: 22%–50%)]. Twenty‐seven patients had a ≥ 50‐point reduction in VAS score and an increased PI ≥ 22.60% [59% (95% CI: 44%–74%)]. Eleven patients had shown a < 50‐point pain reduction in VAS score and increased PI < 22.60% [24% (95% CI: 13%–37%)]. Conclusion: The PI significantly differed between affected and unaffected limbs in patients with CRPS. The PI may be useful for monitoring the response to intravenous ketamine therapy in patients with CRPS.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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