title: Successful reversal of hyperalgesia/myoclonus complex with low-dose ketamine infusion.
abstract: We report the successful use of low-dose ketamine infusion for treating a severe episode of painful myoclonus in the lower extremities, associated with opioid-induced hyperalgesia (OIH), in a patient who was receiving long-term, high dose intrathecal hydromorphone therapy. A low-dose ketamine infusion immediately relieved the painful myoclonus. It also enabled a reduction in the intrathecal opioid dosage leading to a resolution of the acute symptoms attributed to OIH.
authors.affiliation: Department of Anesthesia, St Joseph's Healthcare, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Mauricio
authors.initials: M
authors.lastname: Forero
authors.forename: Philip S L
authors.initials: PS
authors.lastname: Chan
authors.forename: Carlos E
authors.initials: CE
authors.lastname: Restrepo-Garces
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use; D006801:Humans; D004091:Hydromorphone / Q000627:therapeutic use; D006930:Hyperalgesia / Q000139:chemically induced / Q000150:complications / Q000188:drug therapy*; D007262:Infusions, Intravenous; D007649:Ketamine / Q000008:administration & dosage* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009207:Myoclonus / Q000150:complications / Q000188:drug therapy*; D010146:Pain / Q000188:drug therapy
chemical_list: D000701:Analgesics, Opioid; D007649:Ketamine; D004091:Hydromorphone