Ketamine Infusion


Ketamine is an anaesthetic that is used to treat chronic pain syndromes, particularly conditions related to the nervous system. The drug was first introduced in the 1960s and it is meant to reduce sensitivity to pain.

Ketamine infusion treatments can be used to help patients experiencing chronic pain, especially those who are poorly responsive to opioid analgesics, physiotherapy, routine pharmacotherapy, etc., facilitate a multidisciplinary approach to ongoing pain management and to improve their quality-of-life.

The administration of low-dose ketamine infusion therapy in a clinically controlled setting has been well-established through international practices and guidelines, which our clinic follows when providing this treatment.

Always consult with your doctor prior to your procedure to determine if you possess any relative or absolute contraindications and establish whether or not low-dose ketamine infusion therapy is right for you.

How does it work?

In low controlled doses, ketamine infusion therapy produces pain relief. This is most likely due to the inhibition of a receptor called N-methyl D-aspartate (NMDA) on nerve cells. These receptors are particularly active in hyperalgesic states. Ketamine administered as a continuous IV infusion may improve analgesia.

What does it treat?

Ketamine infusions can be used at sub-anaesthetic doses to treat chronic pain syndromes like complex regional pain syndrome type 1 (CRPS-1), post-herpetic neuralgia, and neuropathic pain from peripheral nerve damage, such as diabetic peripheral neuropathy.

It has also been tested in controlled trials for the efficacy of pain relief on chronic pain conditions such as:

 

 

Are there any risks?


In clinical practice, the most common side effects of ketamine infusions may include:

  • Drowsiness
  • Dizziness
  • Dry mouth

The less common side effects are:

  • Nausea and vomiting
  • Memory deterioration, etc.

How are ketamine infusions administered?


Your doctor will determine your dose of ketamine based on your body weight. The standard duration of the infusion treatment is four hours. Treatment sessions may be planned on a weekly or bi-weekly basis with an average of six sessions prescribed to a single patient.

A nurse will observe you during and for an hour after your ketamine IV administration. This monitoring will be conducted in the same place where the treatment was performed. You will be awake for the duration of the treatment. You may experience side effects like drowsiness and dizziness during the infusion.

Intervals for subsequent infusion cycles are as needed, with a usual follow-up within one month of the initial infusion. During your follow-up appointment, your doctor will reassess your case and adjust your course of treatment.

Do I need someone with me during my ketamine infusion?


You do not require accompaniment to your ketamine infusion appointment, however, it is recommended that you arrange a ride home. Driving or operating heavy machinery is not permitted until 24 hours after your treatment.

How should I prepare for my ketamine infusion?

Pre-ketamine infusion instructions include:

  • If scheduled for a ketamine infusion you must stop eating at least 8 hours before your scheduled infusion start time. You may continue clear liquids up to 2 hours prior to your infusion and take your medications with a sip of water up to 2 hours prior to your infusion start time.
  • Food and beverages are NOT permitted during the infusion. The medication given in the infusion decreases your level of consciousness and may cause nausea and vomiting. No caffeine prior to or during treatment is allowed.
  • You should dress in loose fitting clothing. Patients receiving ketamine infusion may be asked to get into a surgical gown to allow easy placement of cardiac monitors.
  • We encourage all patients to use the restroom prior to the start of their ketamine infusion. We understand that the use of the bathroom cannot be controlled. If you need to use the bathroom during your infusion, your infusion will be stopped for 15 minutes prior to transport to the bathroom as this will allow you to become more awake and steady on your feet.
  • Reading or watching movies during the infusion is not allowed and cell phones should be turned off during treatment.
  • You may listen to relaxing music with headphones during infusions. The more relaxed you are during your infusion, the better the results will be.
  • You may continue all your other medications up to the morning of your infusion unless specifically instructed otherwise by your physician.
  • Complete any ordered blood work or EKG. If ordered, we cannot schedule your infusion until these tests are reviewed by your physician.

Post-ketamine infusion instructions include:

  • You must avoid driving or operating heavy equipment for 24 hours after ketamine infusion.
  • You must have a responsible adult to drive you home after your infusion and have a responsible adult with you for 24 hours after low dose ketamine infusions.
  • It is recommended that you avoid strenuous activity after your infusion. Brain rest is recommended after ketamine infusions. It is OK to listen to music and read. Watch TV with caution.
  • Go to the emergency room if you experience chest pain, hives, shortness of breath, increasing weakness, or swelling of your IV site with redness. It is normal to feel fatigue the day of treatment.
  • With ketamine you may experience bad dreams or other thoughts. If this occurs please notify your physician at the time of your next infusion. He or she may provide a medication to help limit these side effects.

 

 

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