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