Ketamine for Chronic Pain

Abstract

The treatment of chronic pain is a chronic problem for many specialities. It is generally based on an approach with antidepressants, anti-epileptics and opioids as drugs of first choice. It has been worked by many different protocols. Ketamine, which is known as a good anaesthetic, has been used for chronic pain. When the pain has a neuropathic component, ketamine is a promising treatment for pain management. Ketamine: by inhibiting the N-methyl-D-aspartate receptor and having some other effects like enhancement of descending inhibition and anti-inflammatory effects at central sites, takes part in chronic pain management. Besides having analgesic effects, there are some concerns about the side effects of ketamine. Some psychedelic symptoms as hallucinations, memory defects, panic attacks, nausea and vomiting, somnolence, cardiovascular stimulation and sometimes hepatoxicity may be seen in patients. Ketamine is generally well-tolerated in clinical settings. Close monitoring of patients receiving ketamine should be mandatory in order to be aware of central nervous system, haemodynamic, renal and hepatic symptoms as well as abuse.