Ketamine for Acute-on-Chronic Pain

Abstract

Background: Ketamine is a N-methyl D-aspartate antagonist that blocks pain stimuli transmission and could prove useful for the complex treatment of acute-on-chronic pain. Setting: A low-dose ketamine protocol as an adjunct to conventional treatment was implemented in a major urban center. Aim: To explore the research question “what is the effect of low-dose ketamine continuous intravenous infusions on pain of highly opioid tolerant adults following spinal surgery?” Participants: All patients had spine surgery and used a minimum of 100mg of oral morphine equivalent pre-operatively. Methods: A retrospective chart review was conducted. Data from individuals treated with conventional therapy from the year prior to protocol implementation were compared to data from those who also received ketamine post-implementation. Outcome measures included pain scores and daily opioid consumption on post-operative day 0 through 5, time to ambulation, time to discharge and adverse effects. Results: There were no statistically significant differences between conventional therapy and ketamine patients.