Cover

Chronic Pain and Addiction

Editor(s): Clark M.R. (Baltimore, Md.) 
Treisman G.J. (Baltimore, Md.) 
Table of Contents
Vol. 30, 2011
Section title: Paper
Clark MR, Treisman GJ (eds): Chronic Pain and Addiction. Adv Psychosom Med. Basel, Karger, 2011, vol 30, pp 139–161
(DOI:10.1159/000324071)

Ketamine in Pain Management

Cohen S.P. · Liao W. · Gupta A. · Plunkett A.
aPain Management Division, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, Md., bPain Management Division, Department of Anesthesiology, University of Pennsylvania School of Medicine, Philadelphia, Pa., and cDepartment of Surgery and dAnesthesia Service, Department of Surgery, Walter Reed Army Medical Center, Washington, D.C., USA

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Abstract

Ketamine is an N-methyl-D-aspar tate receptor antagonist that has been in clinical use in the USA for over 30 years. Its ability to provide profound analgesia and amnesia while maintaining spontaneous respiration makes it an ideal medication for procedure-related pain and trauma. In the chronic pain arena, its use continues to evolve. There is strong evidence to support its short-term use for neuropathic and nociceptive pain, and conflicting evidence for preemptive analgesia. Its potential ability to prevent ‘windup’ and, possibly, ‘reboot’ aberrant neurologic pathways in neuropathic and central pain states has generated intense interest. However, the long-term use of ketamine for chronic neuropathic pain is limited by its side effect profile, and is largely anecdotal. More research is needed to better ascertain its long-term efficacy and side effects, to determine the ideal candidates for sustained treatment and to develop means of exploiting the antinociceptive properties of ketamine while minimizing the adverse effects.



Copyright / Drug Dosage

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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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