Affiliation:
1. Department of Palliative Medicine, Marshfield Clinic, Marshfield, WI.
Abstract
A history of an escalating chronic intractable pain in a patient with cryoglobulinemia, vasculitis, and severe cutaneous ulcerations is presented. A strategy
of progressive, multi-agent, N-methyl-D-aspartate-receptor (NMDA-R) blockade
that resulted in adequate pain control and a three-fold reduction in opioid consumption is described. Diagnostic process of neuropathic pain and the role of
NMDA-R in the development of hyperalgesia are briefly reviewed. Thereafter, existing clinical literature describing the use of Ketamine, a major NMDA-R antagonist for management of malignant pain, is reviewed. Lastly, evidence-based original protocol for intravenous adjuvant Ketamine analgesia for severe cancer pain
is presented.
Key Words: Cancer, Ketamine, pain
Publisher
American Society of Interventional Pain Physicians
Subject
Anesthesiology and Pain Medicine
Cited by
36 articles.
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