Ketamine Pain Management

It is possible that the world of veterinarian medicine has had the secret to pain management all along. For 200 years, doctors for humans have been prescribing morphine for managing their patient’s pain. It has been the standard tool in the battlefield of analgesia, but ketamine is quickly taking over for pain management use.

This PCP (phencyclidine) derivative has been used in veterinary medicine for years. Commonly referred to as a “horse drug”, this may be one of the best and most effective tools for pain management.

Army combat medics have rated ketamine to be more effective than fentanyl or morphine when it comes to providing soldiers quick relief of severe pain.

Different From Morphine

Morphine can cause a patient hypotension or respiratory depression. Ketamine, on the other hand, is unique in the fact that the pharyngeal-laryngeal reflexes are retained and cardiac function isn’t depressed, but stimulated instead.

NMDA Receptors Are Inhibited

The drug ketamine inhibits the action of NMDA (N-methyl d-aspartate) receptors in the body. With low dosage, it is just as a powerful of an analgesic and a mild sedative that produces euphoria. When given at a higher level, it responds as a dissociative anesthesia, providing the patient a sedation that is moderate to deep.

When higher doses were given in a nonclinical setting, it was noted that ketamine can cause patients to hallucinate. This could be a problem because it would appear to be the same as “Angel Dust” or “Special K”, a street drug.

When used in surgical settings, it is recommended for patients that have experienced hallucinations previously with ketamine, be given 10 mg dose of diazepam by IV 5 minutes prior to the ketamine and then again afterward to minimize another incident.

Not A First Line Drug

Even though ketamine is an effective drug on humans as well as horses, it is still not considered to be a first-line of pain management therapy. There are those in the medical profession that believe it should be used earlier in treating a patient with chronic pain.

The safety profile of ketamine is favorable and is highly suitable in challenging environments, such as a surgical anesthesia in the primitive settings that the military may find themselves. The FDA (Food and Drug Administration) concurs with the findings of the military medical personnel that ketamine does have a wide margin of safety and even when overdose has occurred, the recovery of a patient has been complete.

There have been very few deaths attributed to ketamine when used as a single agent according to a study at Walter Reed National Military Medical Center. When the drug used in the military wards, there were no instances associated with the drug that required changes in therapy. This was even when it was used in conjunction with patient-controlled analgesia.

Acute pain is minimized by ketamine because it blocks the NMDA glutamate receptors. A decrease has been noted in the wind-up pain, which amplifies incoming pain, that is caused by a continual attack on the central nervous system.

Hyperalgesic Patients, A Dream Come True

For patients that are hyperalgesic from either nerve damage or from opioid use, they don’t always have a normal response to normal peripheral blocks. For those patients, ketamine can be the dream come true in regards to a pain management that helps them, allowing their regular treatment plans to work. Morphine is more effective in some cases when taken with small doses of ketamine. It has also proven to calm patients too.

PTSI Affects

There is a less physical risk to patients given ketamine, but there are concerns about psychosomatic effects. Research is continuing and experts believe that will put to rest when the findings are released.

Audrey has been a Freelance Writer for 8 years. She lives with her husband of 38 years in a small North Texas town. They have 3 grown children, 5 grandchildren. They find antique stores, flea markets, garage sales, and resale shops to be a necessity as they restore their 100-year-old house they live in.