Ketamine Infusion Therapy

Ketamine infusion therapy is use of ketaminw,  a  potent anesthetic for  treatment for Complex Regional Pain Syndrome.

This was conceptualized by neurologist Dr Robert J. Schwartzman.

The basis for using it to treat CRPS may reside in its strong ability to block  N-methyl D-aspartate (NMDA) receptors.There is sufficient evidence to suggest that a intense or prolonged painful stimulus causes an extraordinary release of glutamate from peripheral nerve fibers that carry pain information.

This glutamate stimulates NMDA receptors on second-order neurons that produce the phenomena central sensitization.

Thus it seems reasonable that by blocking NMDA receptors, one might also be able to block cellular mechanisms supporting windup and central sensitization.

Ketamine is a potent NMDA-blocking drug  and  prolonged infusion of ketamine appears to maintain a level of ketamine in the central nervous system long enough to reverse the effects of the sensitization process and associated pain.

The ketamine infusion therapy can be done by three methods.

ketamine infusion therapy

Techniques of Ketamine Infusion Therapy

Low Dose Ketamine Infusion Therapy

It is also called awake technique or in hospital technique

In this technique, the patient receives a dose of between 20 mg and 35 mg of Ketamine depending on the patients weight, complex regional pain syndrome, health, and a variety of other factors.

In-hospital  treatment has been said to have the highest success rate and highest relief retention rate.

Outpatient Ketamine Infusion Therapy

The out-patient version usually entails repeated infusions done over a period of days, weeks, and months. The treatments are gradually stepped  down as the treatments progress

High Dose Ketamine Infusion Therapy

In this version, the patient is placed into a medically-induced coma and given an extremely high dosage of Ketamine; typically between 500-700 mg per hour for 5 to 7 days.

However, the ketamine thearpy does not have final word on it yet. There are no credible reports in the peer-reviewed literature of such immediate and long lasting effects from this treatment.

Proper clinical trials are required before we know the effects and the risks of this procedure.

Ketamine infusion therapy has also been used with success for treatment of depression.

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Comments

  1. Arthur Rosenthal says

    I have a 45 year old soon suffering from CRPS from, allegedly, trauma suffered in an automobile accident three years ago. He has undergone ketamine infusion therapy and this gives him relief for a about three months. Is there any new treatments for this condition? His suffering continues and he is virtually totally disabled and has pain most of the time.

  2. Dr Arun Pal Singh says

    @Arthur Rosenthal,

    Yes! CRPS can be very bad. I do not think there is any addition to the treatment options.

  3. Darrin Pope says

    I have M.s and have been suffering with extreme eye pain not associated with optic nerve damage am on oral ketamine treatment as well as a fentanyl skin patch also eye is covered I have recieved ketamine infusion but only as a single dose as lack of resources in the NHS won't permit more is there any clinics I can go to recieve the infusion therapy I find it quite affective however my pain consultant is leaving his post and there is nobody else willing to provide the therapy

  4. Dr Arun Pal Singh says

    @Darrin Pope,

    Please have a word with your pain consultant. He might be able to guide you to someone.

    I am very sorry but I would not have any idea of health care system in your country.

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