Oral ketamine therapy in the treatment of postamputation stump pain.
BACKGROUND
Hyperactivity of N-methyl-D-aspartate (NMDA) receptors may be one of the factors in the maintenance of postamputation stump pain.


METHODS
Ketamine-a clinical available NMDA receptor antagonist-was administered intravenously to a patient with established stump pain in a double-blind saline-controlled fashion. Following infusion stump pain was alleviated for 31 hours. Ketamine reduced the allodynic area and wind-up-like pain and increased pressure-pain thresholds. Treatment was started with ketamine 50 mg x 4 per day dissolved in juice. No side effects or development of tolerance were observed during a 3-month treatment period.


CONCLUSIONS
NMDA receptor antagonists may have a potential in the treatment of neuropathic pain, including stump pain.
Nikolajsen
L
L
Department of Neurology, Aarhus University Hospital, Denmark.
Hansen
P O
PO
Jensen
T S
TS
D000284:Administration, Oral; D000672:Amputation Stumps; D018691:Excitatory Amino Acid Antagonists / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007649:Ketamine / Q000008:administration & dosage* / Q000009:adverse effects; D007866:Leg / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D017288:Pain Threshold / Q000187:drug effects; D016194:Receptors, N-Methyl-D-Aspartate / Q000037:antagonists & inhibitors
D018691:Excitatory Amino Acid Antagonists; D016194:Receptors, N-Methyl-D-Aspartate; D007649:Ketamine