title: The use of ketamine as adjuvant therapy to control severe pain.
abstract: Ketamine used in conjunction with other analgesics has dissociative, analgesic, sedative, and amnesic properties. Ketamine potentiates opiates and analgesics, is rapid acting, and is relatively safe. The United Kingdom and United States use ketamine with opioids in adjuvant pain management for a variety of conditions, including cancer pain. Adults and children benefit from the analgesic effects of these medications, especially at the end of life when the reduction of severe cancer pain has refractory or dose-limiting effects. For adults, ketamine and opioids are administered by a patient-controlled analgesia pump. The medication combination has decreased use of opioids and increased activities of daily living. Nursing considerations include close monitoring of vital signs during the initial dosage and follow-up observations of the effectiveness of the medications. Vital signs are checked every four hours after the initial dosage along with evaluation of the effectiveness of the dosage and observation for signs of oxygenation of tissue. Patients have better mobility and quality of life when receiving ketamine as an adjuvant therapy, which promotes assistance with their nursing care. Side effects may occur from administering ketamine and include nausea, vomiting, dizziness, and emotional distress. Standard orders help alleviate problems with those symptoms.
authors.affiliation: Ohio State University Comprehensive Cancer Center-Arthur G. James Cancer Hospital and Richard Solove Research Institute, Columbus, USA. janis.campbell-fleming@osumc.edu
authors.forename: Janis M
authors.initials: JM
authors.lastname: Campbell-Fleming
authors.forename: Amy
authors.initials: A
authors.lastname: Williams
mesh_terms: D000328:Adult; D016058:Analgesia, Patient-Controlled / Q000379:methods / Q000451:nursing; D000700:Analgesics / Q000009:adverse effects / Q000737:chemistry / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000627:therapeutic use; D016903:Drug Monitoring / Q000451:nursing; D004359:Drug Therapy, Combination; D018691:Excitatory Amino Acid Antagonists / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007649:Ketamine / Q000009:adverse effects / Q000737:chemistry / Q000627:therapeutic use*; D009369:Neoplasms / Q000150:complications*; D024802:Nurse's Role; D009859:Oncology Nursing; D010146:Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D010147:Pain Measurement; D016194:Receptors, N-Methyl-D-Aspartate / Q000037:antagonists & inhibitors; D013727:Terminal Care / Q000379:methods
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid; D018691:Excitatory Amino Acid Antagonists; D016194:Receptors, N-Methyl-D-Aspartate; D007649:Ketamine