Ketamine Infusion Therapy for CRPS
What is Ketamine?
Ketamine is a derivative of phencyclidine (PCP) that was first developed in 1962 and was first tested on humans in 1964. It has proved to be a better option as a dissociative anesthetic than PCP, largely because it has less psychomimetic (mimicking psychosis) effects and is a shorter acting drug. After FDA approval in 1970, it was first used pharmacologically on soldiers in the Vietnam War.
Ketamine is classified as an NMDA receptor antagonist and is used in low doses as a dissociative anesthesia, meaning that the effect of ketamine causes an interference of pain transmission in the spinal cord. Ketamine inhibits the production of nitric oxide, which is a neurotransmitter that is involved in the pain perception mechanism. Ketamine also affects several other receptors, many of which result in analgesia, or pain relief.
Utah Ketamine Infusion Treatments
At Omega, ketamine infusion is done as a multi-day outpatient therapy. Patients usually do a four hour session on 3-5 consecutive days with a steady continuous or increasing dose each day as tolerated. Studies have shown that a single dose has little affect on relieving CRPS related pain; where as multiple consecutive doses have proven to be the most effective ketamine based treatment of CRPS. Anyone undergoing ketamine infusion therapy will require someone to transport them home from each session, as they will not be able to drive safely.
Although ketamine therapy is not widely available and is considered somewhat controversial, continual studies have shown that it is extremely effective in relieving pain in patients suffering from CRPS. Much of the controversy about low-dose ketamine infusion therapy results from it being confused with ketamine coma therapy, which is used only in extreme cases where the patient is put in a medically induced coma and given large doses of ketamine for 5 days before being awaken from the coma. This procedure, however, is currently not actively practiced in the United States. It is more commonly performed in Germany and Mexico.
As with any medication, there are possible side-effects. They can, however, all be controlled by adding additional medications as needed. Some possible side-effects include dizziness, blurred vision, nausea, euphoria, and hallucinations. Versed, for example, can be added if hallucinations occur. Vital signs are monitored electronically and a nurse oversees care for the duration of the infusion, noting sweating, flushing, allodynia, etc. to keep adverse side-effects to a minimum.
Pain Education Center
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