Introduction
Ketamine is a highly specialized pain management drug. Ketamine was invented in 1960s and was majorly used in anesthesia (Sherman, et al. 2016, p.58). Today, ketamine is used in emergency or disaster relief anesthesia. Veterinary officers also use it as an anesthetic agent. The use of ketamine in chronic pain management arose when patients recovering from anesthesia who experienced severe pain reported improvements in their pain. These patients also reported that the pain relief could sometimes last for months following ketamine anesthesia. Ketamine is usually used in the treatment of neuropathic pains in severe conditions such as Complex Regional Pain Syndrome (Sherman, et al. 2016, p.58).
Ketamine Infusion
Ketamine infusion is a specialized analgesia technique used in the management of moderate to severe pain. Administering a ketamine infusion is a procedure that involves the delivery of recommended doses of ketamine intravenously in a hospital setting (Liu, Zerbo, & Ross, 2014). The procedure involves the insertion of a plastic cannula into a vein in the arm and the ketamine is administered through a computer-aided infusion pump. Patient’s vital signs such as pulse rate and blood pressure are monitored regularly. Pain level and infusion are also monitored hourly by the physician. Ketamine infusion may also be administered along with opioids. The use of opioid infusions alone may minimize opioid tolerance when prolonged administration of opioids is anticipated or may result in inadequate analgesia (Liu, Zerbo, & Ross, 2014).
In some situations, ketamine infusions may also be used alone.
Use of Ketamine in Analgesic Therapy for Pain Patients
Ketamine is a noncompetitive N-methyl-d-aspartate antagonist receptor. It is widely used in pain management and anesthesia. Ketamine works acts by binding to the phencyclidine site on postsynaptic channels and reduces the opening time and frequency of ion channels. The inhibition caused by ketamine at the NMDA receptor is dose-depended in that the recovery and onset from the inhibition are increased by administering NMDA agonists. The use of ketamine in the management of chronic pain is related to nerve or neuropathic pain. It is considered a third-line agent when first and second-line agents such as anti-depressants, anti-seizure medications, and narcotics do not adequately relieve pain.
Physical Effects of Ketamine
The use of ketamine is associated with various short-term and long-term effects. Individuals who have used ketamine report that the effects are similar to the effects of Lysergic acid diethylamide (LSD), a hallucinogenic drug (Luckenbaugh, et al. 2014, p.59). The hallucinations can last for up to one hour after their manifestation, but other effects can last for up to 24 hours from the previous use of the drug. Other physical effects associated with ketamine use include:
Increased salivation
Dizziness
Slurred speech
Extremely rapid heart beat
Vomiting
Seizures
Immobility
Lack of memory or blackout
Rapid, uncontrollable eye movements
Psychological effects of Ketamine
The psychological effects associated with the use of ketamine can be as intense as the physical effects of using the drug (Luckenbaugh, et al. 2014, p.60). They can include:
Impaired cognitive ability
Sedation
Lesser awareness of the environment
Vivid dreams
A feeling of disorientation
Chest pain
Inability to concentrate
Intense hallucinations
Altered perception of body, sounds, environment, and time
Conclusion
In summary, ketamine is a specialized pain management drug used in anesthesia. Today, ketamine is used in emergency or disaster relief anesthesia and vets use it as an anesthetic agent. Ketamine infusion is an analgesia technique used in the management of moderate to severe pain and involves the delivery of recommended doses of ketamine intravenously in a hospital setting. Ketamine is a noncompetitive NMDA antagonist receptor used in pain management and anesthesia. Its use is associated with various physical and psychological effects such as hallucination, sedation, vomiting, and rapid heartbeat.
References
Luckenbaugh, D. et al. (2014). Do the dissociative side effects of ketamine mediate its antidepressant effects? Journal of affective disorders, 159, 56-61.
Liu, J. X., Zerbo, E., & Ross, S. (2014). Intensive ketamine use for multiple years: A case report. The American journal on addictions.
Sherman, S. J., Estevez, M., Magill, A. B., & Falk, T. (2016). Case Reports Showing a Long-Term Effect of Subanesthetic Ketamine Infusion in Reducing L-DOPA-Induced Dyskinesias. Case reports in neurology, 8(1), 53-58.
