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What Is It?

Ketamine is a medication invented in the 1960’s as an anesthetic agent often used during invasive operations. In low doses, ketamine is used for chronic pain management and the treatment of depression.

What Does It Do?

Ketamine manages chronic pain by acting on a receptor of the central and peripheral nervous system called N-methyl-D-aspartate as an antagonist. NMDA promotes the amplification of nerve signals, central sensitization and opioid tolerance. By antagonizing the NMDA receptor, ketamine provides pain-relieving effects.

What Is It Used For?

Ketamine infusions can be used for patients with chronic pain that is not well-managed with commonly used pain medication or other noninvasive treatment options. Its analgesic effects have been shown in patients with CRPS, neuropathy (nerve pain), cancer pain, fibromyalgia, postherpetic (Shingles) neuralgia and diabetic neuropathy.

Evidence

In a retrospective series study, conditions that effectively responded to the ketamine infusions were most commonly CRPS, refractory back pain and intractable headache. All of these chronic pain conditions experienced analgesic effects of the ketamine of varying durations. Half of the conditions received pain relief for 3 weeks.

In a study on cancer-related neuropathic pain, 7 out of 9 patients who received an oral dose of 0.5 mg/kg ketamine 3 times a day in addition to their already established morphine routine reported a decreased pain score greater than 3 points. 4 patients experienced nausea as a side effect, 2 a loss of appetite, and 8 sedation. The results demonstrate that in low doses, ketamine can be an effective treatment option for refractory neuropathic pain management in cancer patients.

A retrospective review of 33 patients with CRPS treated with a ketamine infusion, 76% of patients had complete pain relief and 18% had partial pain relief. For all 12 patients who received a second course of treatment, complete pain relief was achieved.

Dr. DeCaria is a double-board certified physician in anesthesiology and pain management medicine with extensive training and experience in treating chronic pain with trigger point injections.

Schedule your appointment with Dr. DeCaria of Revitalize Medical Center in Glenview and Evanton, IL, to take the first step towards a long-term solution for your chronic pain!

References:

Connolly, S., Prager, J., & Harden, R. (2015, May 19). Systematic Review of Ketamine for Complex Regional Pain Syndrome. Retrieved September 30, 2020, from https://academic.oup.com/painmedicine/article/16/5/943/2460721

Correll, G. E., Maleki, J., Gracely, E. J., Muir, J. J., & Harbut, R. E. (2004). Subanesthetic ketamine infusion therapy: a retrospective analysis of a novel therapeutic approach to complex regional pain syndrome. Pain medicine (Malden, Mass.), 5(3), 263–275. https://doi.org/10.1111/j.1526-4637.2004.04043.x

Kurdi, M. S., Theerth, K. A., & Deva, R. S. (2014). Ketamine: Current applications in anesthesia, pain, and critical care. Anesthesia, essays and researches, 8(3), 283–290. https://doi.org/10.4103/0259-1162.143110

Zgaia AO, Irimie A, Sandesc D, et al. The role of ketamine in the treatment of chronic cancer pain. Clujul Med. 2015;88(4):457-461. doi:10.15386/cjmed-500

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