Analgesic effect of subanesthetic intravenous ketamine in refractory neuropathic pain: a case report

Pain Medicine : the Official Journal of the American Academy of Pain Medicine
Osama ElsewaisyJohn Monagle

Abstract

A 59-year-old male patient with progressive neuropathic pain secondary to chronic idiopathic axonal polyneuropathy responded poorly to conventional therapies including gabapentin, tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors and opioids. Following continuous intravenous administration of low dose ketamine, an N-methyl-D-aspartic acid receptor antagonist, 20 mg/h for 5 days, almost complete pain relief was obtained without significant side effects. The analgesic effect lasted 10-12 weeks and the ketamine infusion was repeated, with this pattern being maintained for 3.5 years. This supports the growing body of evidence that ketamine may be useful in the management of refractory chronic neuropathic pain. We discuss chronic idiopathic axonal polyneuropathy, neuropathic pain mechanisms, and the use of ketamine in this report.

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Citations

Mar 25, 2014·Pain Management·Dalia H ElmoftyAsokumar Buvanendran
Mar 25, 2015·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Plato MakColin S Goodchild
Aug 8, 2014·Journal of Pain & Palliative Care Pharmacotherapy·Priya AminRabia Atayee
Apr 10, 2013·Toxicology Letters·Chaoxuan Dong, K J S Anand

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