Introduction
Ketamine is an anaesthetic and pain-killing drug which is used to treat neuropathic pain not responsive to more simple medication. It is also useful to achieve opioid dose reduction. Ketamine infusion involves the introduction of ketamine in controlled doses, which might reduce the level of pain long term and improve the effectiveness of other pain medication which means that lower doses of pain medication are more effective. Not everyone responds to ketamine in this way.
Preparing for a ketamine infusion: no special preparations are needed.
Procedure
A ketamine infusion is only carried out in hospital and is delivered intravenously, and generally requires a hospital stay of around a week (depending on your response to the infusion).
A catheter is placed into a vein (generally in the arm, but sometimes in the skin of the abdomen) and an infusion pump delivers the correct dose of ketamine. During the infusion your pain level is monitored as well as your other vital signs, such as blood pressure and heart rate. Ketamine is a very safe drug.
You will not be confined to a hospital bed, but you will not be allowed to leave the hospital ward. You will be able to wear everyday clothes and move around.
The commencing dose is low to check your sensitivity to ketamine. Once this first dose has been evaluated, the dosage is gradually increased and monitored until the right level is reached, or until any side effects become noticeable. This first treatment will then set the parameters for any further ketamine infusions.
It is important to note that not all patients get meaningful long-term benefit from ketamine.
Side effects
Some side effects may be caused by ketamine, although control of dosage levels should minimise or eliminate these. Common side effects include…
- Blood pressure increase.
- Higher heart rate.
- Headache.
- Light-headedness.
- Tingling sensation.
- Emotional reaction.
- Transient hallucinations.
- Nausea.
Some patients develop liver abnormalities, and in that case, the infusion may need to be ceased.
Postoperative Instructions
You will be followed up after your ketamine admission.
We will give you instructions on which pain medication to continue to take after the ketamine infusion and at what dosage levels. You will also be asked to book an appointment to come and see us a week or two after leaving hospital.