Ketamine

Ketamine
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  • Ketamine for Chronic Pain: Risks and Benefits
  • Lisa, I think its time you saw your specialist again
  • Ahhhh! My back is killing me! I can't even do things I enjoy anymore because of this chronic pain
  • Dr Edwards has decided to admit Lisa for a Ketamine infusion
  • Ok Dr, I'll give anything a try, but what is Ketamine?
  • Infusions that last 4-14 days have been shown to produce long-term pain relief for up to 3 months
  • It's an anaesthetic used to treat chronic pain. At low doses it can produce strong analgesia for neuropathic pain.
  • Treatment of chronic pain is based on trial and error. Ketamine was initially used by anaethetists and pain doctors at subanaesthetic doses to treat therapy-resistant chronic pain with a neuropathic component. It passes the blood-brain barrier rapidly with rapid onset of analgesia
  • I love Ketamine!
  • Lisa is about to be admitted for a continuous ketamine infusion of 20mg/hour over 5 days
  • Dr Edwards, how does ketamine actually work?
  • Good question.. by inhibiting the N-methyl-D-aspartate receptor - an excitatory receptor involved in transmission of nociceptive signals
  • Ketamine stops excessive nociceptive input to the brain
  • He has, but can you remind me?
  • Sure, the most common effects you may experience are hallucinations, memory defects, nausea/vomiting, fatigue and a fast heart rate. Please let me know if you develop these symptoms.
  • Lisa, has Dr Edwards discussed the side effects you may experience?
  • Niesters, M, Martini, C & Dahan, A 2013, 'Ketamine for chronic pain: risks and benefits', British Journal of Clinical Pharmacology, vol. 77, no. 2, pp. 357-367
  • Lisa experienced mild tachycardia as ketamine has a direct negative inotropic effect and an indirect stimulatory effect on the cardiovascular system. Lisa was discharged after her 5 day ketamine infusion and in the months following this she has had a significant decrease in pain level. Despite Lisa's good result, there a still a limited number of studies that assess whether the benefits outweigh the risks and costs.
  • Wow! My pain is so much better! I'm back at the gym and doing everything I usually do
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