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-
1.
Ochoa, JL . :Pain mechanisms in neuropathy. .Curr Opin Neurol 7::407. ,1994. .
-
2.
Sawynok, J . :Topical and peripherally acting analgesics. .Pharmacol Rev 55::1. ,2003. .
-
3.
Coggeshall, RE and SM Carlton. :Evidence for an inflammation-induced change in the local glutamatergic regulation of postganglionic sympathetic efferents. .Pain 83::163. ,1999. .
-
4.
Carlton, SM, GL Hargett, and RE Coggeshall. :Localization and activation of glutamate receptors in unmyelinated axons of rat glabrous skin. .Neurosci Lett 197::25. ,1995. .
-
5.
Jackson, DL, CB Graff, JD Richardson, et al. :Glutamate participates in the peripheral modulation of thermal hyperalgesia in rats. .Eur J Pharmacol 284::321. ,1995. .
-
6.
Lawland, NB, WD Willis, and KN Westlund. :Excitatory amino acid receptor involvement in peripheral nociceptive transmission in rats. .Eur J Pharmacol 324::169. ,1997. .
-
7.
Hocking, G and M Cousins. :Ketamine in chronic pain management: an evidence-based review. .Anesth Analg 97::1730. ,2003. .
-
8.
Warncke, T, A Stubhaug, and E Jorum. :Ketamine, an NMDA receptor antagonist, suppresses spatial and temporal properties of burn-induced secondary hyperalgesia in man: a double-blind, cross-over comparison with morphine and placebo. .Pain 72::99. ,1997. .
-
9.
Felsby, S, J Nielsen, L Arendt-Nielsen, et al. :NMDA receptor blockade in chronic neuropathic pain: a comparison of ketamine and magnesium chloride. .Pain 64::283. ,1995. .
-
10.
Rabben, T, P Skjelbred, and I Oye. :Prolonged analgesic effect of ketamine, an N-methyl-d-aspartate receptor inhibitor, in patients with chronic pain. .Pharmacol Exp Ther 289::1060. ,1999. .
-
11.
Quan, D, BS Wellish, and DH Gilden. :Topical ketamine treatment of postherpetic neuralgia. .Neurology 60::1391. ,2003. .
-
12.
Gammaitoni, A, RM Gallagher, and M Welz-Bosna. :Topical ketamine gel: possible role in treating neuropathic pain. .Pain Med 1::97. ,2000. .
-
13.
Lynch, ME, AJ Clark, J Sawynok, et al. :Topical amitriptyline and ketamine in neuropathic pain syndromes: an open-label study. .J Pain 6::644. ,2005. .
-
14.
Martin, CL, J Albers, WH Herman, et al. :Neuropathy among the diabetes control and complications trial cohort 8 years after trial completion. .Diab Care 29::340. ,2006. .
-
15.
Jensen, MP, P Karoly, EF O’Riordan, et al. :The subjective experience of acute pain: an assessment of the utility of 10 indices. .Clin J Pain 5::153. ,1989. .
-
16.
Jensen, MP, P Karoly, and S Braver. :The measurement of clinical pain intensity: a comparison of six methods. .Pain 27::117. ,1986. .
-
17.
Seymour, RA . :The use of pain scales in assessing the efficacy of analgesics in post-operative dental pain. .Eur J Clin Pharmacol 23::441. ,1982. .
-
18.
Cruccu, G, P Anand, N Attal, et al. :EFNS guidelines on neuropathic pain assessment. .Eur J Neurol 11::153. ,2004. .
-
19.
Beecher, HK . :The powerful placebo. .JAMA 159::1602. ,1955. .
-
20.
Turner, JA, RA Deyo, JD Von Loeser, et al. :The importance of placebo effects in pain treatment and research. .JAMA 271::1609. ,1994. .
-
21.
Moore, RA, D Gavaghan, MR Tramer, et al. :Size is everything: large amounts of information are needed to overcome random effects in estimating direction and magnitude of treatment effects. .Pain 78::209. ,1998. .
-
22.
Davidson, EM, RE Coggeshall, and SM Carlton. :Peripheral NMDA and non-NMDA glutamate receptors contribute to nociceptive behaviors in the rat formalin test. .Neuroreport 8::941. ,1997. .
-
23.
Lu, Y, Y Lou, J Xie, et al. :Tumorigenic effect of some commonly used moisturizing creams when applied topically to UVB-pretreated high risk mice. .J Invest Dermatol 129::468. ,2009. .
-
24.
Perel, P, I Roberts, E Sena, et al. :Comparison of treatment effects between animal experiments and clinical trials: systematic review. .BMJ 334::197. ,2007. .
-
25.
Oatway, M, A Reid, and J Sawynok. :Peripheral antihyperalgesic and analgesic actions of ketamine and amitriptyline in a model of mild thermal injury in the rat. .Anesth Analg 97::168. ,2003. .
-
26.
Becker, E and J Koo. :Clinical focus: the spectrum of topical agents for the treatment of psoriasis .Available at: http://www.medscape.org/viewarticle/588415. .Accessed March 15, 2010.
-
27.
Brisson, P . :Percutaneous absorption. .Can Med Assoc J 110::1182. ,1974. .
Topical Ketamine Cream in the Treatment of Painful Diabetic Neuropathy
A Randomized, Placebo-controlled, Double-blind Initial Study
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Background:
Painful diabetic neuropathy remains a difficult pathologic condition to manage effectively despite numerous pharmacologic interventions. A randomized, placebo-controlled, double-blind study was undertaken to determine whether topical 5% ketamine cream is effective in reducing the pain of diabetic neuropathy.
Methods:
Seventeen diabetic patients completed the study. The Michigan Neuropathy Screening Instrument was used to determine whether the neuropathy was likely caused by the diabetic condition. Hemoglobin A1c levels were measured before treatment. Patients applied 1 mL of either ketamine cream or placebo cream for 1 month. The intensity of seven different pain characteristics was evaluated before and after treatment. A two-way repeated analysis of variance design was used to test for differences between treatments and within patients (time).
Results:
We found no significant treatment main effect, but pain improved significantly over time in both groups. There was no statistical interaction effect (treatment ×time) in any of the pain characteristics, indicating that pain improved in the two treatment groups similarly with time.
Conclusions:
The 5% topical ketamine cream was no more effective than was placebo in relieving pain caused by diabetic neuropathy. (J Am Podiatr Med Assoc 102(3): 178–183, 2012)
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