Editor-in-Chief: Alaa Abd-Elsayed, MD, PhD

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  1. PMCR-2020;4;157-162 IV Ketamine-Induced Skin Temperature Changes in a Patient with Unilateral Complex Regional Pain Syndrome (CRPS) Type II
    Case Report
    Ashraf F. Hanna, MD, and Adam J. Smith, MD.

BACKGROUND: Ketamine is increasingly being utilized off-label for numerous difficult-to-treat conditions when conservative treatment options fail to provide an adequate clinical response. One such condition is complex regional pain syndrome (CRPS). CRPS is characterized by pain, inflammation, vascular abnormalities, and functional decline. While ketamine has been used successfully to treat the disease, its mechanism of action remains hotly debated and not well-understood.

CASE REPORT: Here, we describe a clinical case of CRPS in a female patient who was refractory to conventional treatment options. Skin temperatures were measured in the affected and unaffected limb before, during, and after intravenous infusion with ketamine. We report that skin temperature increased in the CRPS-affected limb despite the known sympathomimetic effects of ketamine expected to produce vasoconstriction.

CONCLUSION: The novel findings presented herein are intended to spur formal well-controlled and powered clinical stud¬ies, which may better elucidate the vascular effects of ketamine in this underserved patient population.

KEY WORDS: Complex regional pain syndrome, depression, esketamine, ketamine hydrochloride, suicidality, thermal imaging