Esketamine as Treatment for Chronic Pain Due to Endometriosis: a RCT Study

Exclusion Criteria

• •Pain score \<6 out of 10 (NRS) for chronic pelvic pain
• •Endometriosis affecting the bladder and ureter
• •Increased intracranial pressure
• •Poorly regulated hypertension, \>180/100mmHg at rest
• •Patients with thyroid disease
• •Patients with cancer
• •History of psychiatric illness (schizophrenia, psychosis, delirium, manic depression)
• •Serious medical disease (e.g., cardiovascular, renal , pulmonary or liver disease)
• •Severe liver disease
• •Patients with glaucoma
• •Usage of strong opioid medication
• •Usage of xanthine derivatives or ergometrine
• •Unstable angina, heart failure, history of cerebral vascular accident (CVA)
• •Patients suffering from an active infection
• •Patients with epilepsy
• •Patients trying to achieve pregnancy and or patients who are breastfeeding
• •Not being able to answer questionnaires (in Dutch)
• •Mentally incompetent (patients not able to make decisions that are in their best interests, this will be evaluated by their treating physician (e.g. patients with an intellectual disability or mental retardation))
• •Alcohol or drug abuse
• •Patient with a known (es)ketamine allergy
• •Abnormal liver enzyme levels at baseline (ASAT, ALAT, GGT, AF, Bilirubin total)
• •Patients are allowed to continue the following pain medications: paracetamol, non-steroidal anti-inflammatory drugs as described previously by Sigtermans et al. (Trial NL466 (NTR507))\* according to their stable use in dose and frequency.
• •\*in case of tramadol, amitriptylin, selective serotonin reuptake-inhibitors, gabapentin and pregabalin, the usage may also be continued during this study.