What Is Ketamine Infusion Therapy For Complex Regional Pain Syndrome

Ketamine is a  potent anesthetic that has been used as an experimental and controversial 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 therapy can be done by a low dose ketamine infusion of between 10–90 mg per hour over several days.

The second treatment modality consists of putting the patient into a medically-induced coma, then administering an extremely high dosage of ketamine; typically between 600–900 mg.

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.

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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.

    • 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.

  2. 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

    • 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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