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.
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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