Instituut voor Neuropathische Pijn
English articles Treatment Low dose Intravenous Ketamine in Refractory Neuropathic Pain
| Low dose Intravenous Ketamine in Refractory Neuropathic Pain |
Treatment of refractory neuropathic pain is a clinical challenge. However, many new case reports and small clinical trials suggest that the N-methyl-D-aspartic acid (NMDA) receptor antagonists ketamine may be clinically useful in treating cases of neuropathic pain. Here a case report. This case report supports the idea that ketamine can be useful in the reduction of refractory chronic neuropathic pain and that the effect of ketamine can persist for many weeks after treatment.
Low dose ketamine infusion for neuropathic painA 59-year-old treatment resistent male patient with neuropathic pain secondary to chronic idiopathic axonal polyneuropathy (CIAP) was treated with a continuous intravenous administration of low dose ketamine, 20 mg/h for 5 days, and this resulted in an almost complete pain relief without significant side effects. The analgesic effect lasted 10–12 weeks after which the ketamine infusion was repeated, and the patient remained responsive to this treatment regime during 3.5 years. NO side effects were reported. This case supports the growing body of evidence that ketamine may be useful in the management of refractory chronic neuropathic pain. In our hands the same effects seem to be possible by administering ketamine in a topical cream. Jan M. Keppel Hesselink, MD, PhD Ref: Analgesic Effect of Subanesthetic Intravenous Ketamine in Refractory Neuropathic Pain: A Case ReportOsama Elsewaisy, MBBS,* Barry Slon, FANZCA, † and John Monagle, FANZCA † Pain MedicineISSN: 1526-4637 (Online)ISSN: 1526-2375 (Print)Volume 11, Issue 6, 2010.Pages: 946–950 |