{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T17:49:24Z","timestamp":1785779364831,"version":"3.56.0"},"reference-count":35,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Anaesth Intensive Care"],"abstract":"<jats:p>Off-label ketamine infusions are often used to manage chronic non-cancer pain (CNCP), including neuropathic pain, central sensitisation and opioid dose reduction. There are variable treatment regimens and routes of delivery based on clinical trials but there is the distinct lack of any clearly defined treatment guidelines. The goal of the scoping review was to determine whether there has been progress with the availability of published guidelines. Our inclusion criteria were publications that contained ketamine infusion, chronic pain and guidelines or protocols. We excluded publications that contained only acute pain, cancer pain or the paediatric population. A literature search was conducted on 10 May 2024 and included the medical scholarly literature databases MEDLINE and Embase and the evidence-based database Trip (formerly Turning Research into Practice; now Trip only; Trip Database Ltd, UK) Pro and limited to English language papers. Additional publications that were encountered during background reading were also included. A total of 42 publications were examined against the inclusion\/exclusion criteria by the first three authors. The included full-text publications were then reviewed to determine whether they were considered a guideline. The three identified publications were then comparatively reviewed against the National Health and Medical Research Council standards for guidelines as a qualitative assessment, with 34\u201376% of standards met. This review found no published guidelines in Australia for use of ketamine in CNCP, despite ongoing clinical use. The authors\u2019 conclusion is that this is an area that should be addressed. Efficacy and adverse effects of off-label ketamine use should be able to be measured against an established guideline. Without a consistent and standard approach, the role of ketamine in this setting is unable to be thoroughly assessed. Such a guideline may be developed through expert consensus.<\/jats:p>","DOI":"10.1177\/0310057x261460082","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T05:49:00Z","timestamp":1785476940000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["A scoping review for published guidelines for use of ketamine in chronic non-cancer pain"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-4023-7095","authenticated-orcid":false,"given":"Meredith L. M.","family":"Daff","sequence":"first","affiliation":[{"name":"Pain Management Unit, The Queen Elizabeth Hospital, Central Adelaide Local Health Network, Adelaide, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie A.","family":"Eblen","sequence":"additional","affiliation":[{"name":"Pain Management Unit, The Queen Elizabeth Hospital, Central Adelaide Local Health Network, Adelaide, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4779-0380","authenticated-orcid":false,"given":"Andrew A.","family":"Somogyi","sequence":"additional","affiliation":[{"name":"Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6633-9261","authenticated-orcid":false,"given":"Kathryn V.","family":"Rough","sequence":"additional","affiliation":[{"name":"Faculty of Pain Medicine, Australian and New Zealand College of Anaesthetists, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5216-3850","authenticated-orcid":false,"given":"Irina B.","family":"Hollington","sequence":"additional","affiliation":[{"name":"Pain Management Unit, The Queen Elizabeth Hospital, Central Adelaide Local Health Network, Adelaide, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,30]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1080\/17512433.2020.1717947"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40262-016-0383-6"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-021-03769-9"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11064-018-2614-8"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.3389\/fncel.2022.999509"},{"key":"e_1_3_3_7_2","volume-title":"Position statement on the use of ketamine in the management of chronic non-cancer pain","author":"Faculty of Pain Medicine, Australian and New Zealand College of Anaesthetists (ANZCA)","year":"2022","unstructured":"Faculty of Pain Medicine, Australian and New Zealand College of Anaesthetists (ANZCA). Position statement on the use of ketamine in the management of chronic non-cancer pain. PS12(PM) and Background Paper. Melbourne: ANZCA, 2022."},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000004185"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejp.1153"},{"key":"e_1_3_3_10_2","article-title":"Effects of ketamine on chronic postsurgical pain in patients undergoing surgery: A systematic review and meta-analysis","volume":"26","author":"Sun W","year":"2023","unstructured":"Sun W, Zhou Y, Wang J, et al. Effects of ketamine on chronic postsurgical pain in patients undergoing surgery: A systematic review and meta-analysis. Pain Physician 2023; 26: E111\u2013E122.","journal-title":"Pain Physician"},{"key":"e_1_3_3_11_2","volume-title":"Rethinking medicines decision-making in Australian Hospitals: Guiding Principles for the quality use of off-label medicines","author":"Council of Australian Therapeutic Advisory Groups (CATAG)","year":"2013","unstructured":"Council of Australian Therapeutic Advisory Groups (CATAG). Rethinking medicines decision-making in Australian Hospitals: Guiding Principles for the quality use of off-label medicines. Sydney: CATAG, 2013."},{"key":"e_1_3_3_12_2","volume-title":"Off-label use of medications: Chief civil psychiatrist clinical guideline 7","author":"Tasmanian Department of Health","year":"2021","unstructured":"Tasmanian Department of Health. Off-label use of medications: Chief civil psychiatrist clinical guideline 7. 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Canberra: NHMRC, 2022."},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2012.03.2023"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.11124\/JBIES-20-00167"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.7326\/M18-0850"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000808"},{"key":"e_1_3_3_19_2","volume-title":"Guidelines for safe administration of low-dose ketamine","author":"Ashburn MA","year":"2020","unstructured":"Ashburn MA, Stiles AS, Miller S, et al. Guidelines for safe administration of low-dose ketamine. Harrisburg: Commonwealth of Pennsylvania, 2020."},{"key":"e_1_3_3_20_2","volume-title":"American College of Occupational and Environmental Medicine (ACOEM) chronic pain guideline","author":"Hegmann KT","year":"2024","unstructured":"Hegmann KT, Weiss MS, Bowden K, et al. American College of Occupational and Environmental Medicine (ACOEM) chronic pain guideline. 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