Effectiveness of Ketamine Administered by Mesotherapy in Complex Regional Pain Syndrome Type 1 (CRPS1)
Status:
Not yet recruiting
Trial end date:
2022-07-01
Target enrollment:
Participant gender:
Summary
Complex Regional Pain Syndrome type 1 (CRPS1) is a disabling pain syndrome. Its definitive
treatment has not been established and the results of current treatments are often
unsatisfactory.
The prognosis is difficult to establish because the vast majority of CRPS regresses within a
few weeks. However, some forms are hyperalgesic with a major chronic painful picture, very
debilitating and responding poorly to treatments with possible permanent sequelae.
The management of CRPS remains difficult and unsatisfactory and is symptomatic,
multidimensional and multidisciplinary involving medical, paramedical and socio-professional
workers. The priority therapeutic objectives are analgesia, maintenance or gain of joint
range and maintenance or restoration of motor functions. This treatment is not the subject of
a consensus and its implementation is sometimes the responsibility of specialized centers
such as "pain relief" centers or even Physical Medicine and Rehabilitation (MPR) structures.
Previous studies using ketamine as a treatment for CRPS1 show encouraging results with a
decrease in neuropathic pain. Ketamine is a low dose pain reliever. Ketamine has been studied
as an adjuvant for the treatment of chronic pain, particularly neuropathic pain. The results
suggest that ketamine decreases pain intensity and reduces opioid reliance when used as an
adjunct to chronic and acute pain. Ketamine is believed to have a greater analgesic effect in
patients with CRPS1 compared to other chronic pain syndromes. In these studies, ketamine was
used intravenously, subcutaneously, orally, intranasally, or topically.
Mesotherapy allows microdose local treatment to be carried out limiting side effects,
ensuring compliance and easy to implement. The injected solutions often contain a local
anesthetic (procaine or lidocaine). It allows better local tolerance from the start of
treatment. In addition, through its vasodilator effect on the microcirculation, it increases
the effectiveness and tolerance of other injected products.
There are no studies using ketamine administrated by mesotherapy. Based on the scientific
literature, there are good reasons to believe that this treatment could be effective on the
neuropathic pain of CRPS1 and well tolerated.