title: The use of ketamine in severe cases of refractory pain syndromes in the palliative care setting: a case series.
abstract: The benefits of ketamine in reducing pain are largely based on case reports and small clinical trials. We present a case series describing the application and efficacy of subanesthetic doses of ketamine in the treatment of complex pain syndromes poorly responsive to escalating doses of opioids. The discussion that follows suggests that subanesthetic intravenous ketamine can be used to successfully treat severe pain of different etiologies refractory to opioid dose escalation. Optimal dosing titration, duration of initial treatment, and the role of maintenance ketamine need to be further elucidated. Our case series adds to the extant literature supporting the role of subanesthetic ketamine for refractory pain problems.
authors.affiliation: The Center for Hospice and Palliative Care, Buffalo, New York, USA. ckerr@palliativecare.org
authors.forename: Christopher
authors.initials: C
authors.lastname: Kerr
authors.forename: Timothy
authors.initials: T
authors.lastname: Holahan
authors.forename: Robert
authors.initials: R
authors.lastname: Milch
mesh_terms: D000328:Adult; D000368:Aged; D000700:Analgesics / Q000008:administration & dosage / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007649:Ketamine / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010148:Intractable Pain / Q000188:drug therapy*; D010166:Palliative Care
chemical_list: D000700:Analgesics; D007649:Ketamine