Intravenous Ketamine Infusion – Would it Relieve Your Chronic Pain?

Ketamine is a drug normally used in anesthesia to create a state of unconsciousness, dissociation or sedation. The effects depend on the dose. It has been used throughout the world since the 1960’s.

Recently, it has been used to treat many chronic pain syndromes like CRPS, treatment-resistant fibromyalgia, post-herpetic neuralgia and severe depression.

There are over 1,000 publications promoting use of Ketamine for reasons other than anesthesia.

Low dose Ketamine infusion for nerve pain:

Benefits include reduced pain in the short term (during the infusion) and in the long term (up to two weeks after the infusion). 

Physiology:

The mechanism is thought to work by inhibiting an N-Methyl-D-Aspartate receptor. Without inhibition, inflammatory molecules in the spinal cord activate this receptor, which dials up pain intensity inside the central nervous system as it travels to the brain.   

Procedure:

The patient is brought to the post-operative recovery area at Restore Surgery center, where he or she will change into a gown and be placed in a hospital-type bed. We monitor the patient’s heart rate, rhythm and oxygen saturation.

A nurse will place a small gauge IV catheter and a saline solution will be delivered at a low rate. We deliver the ketamine through a special syringe pump. The rate is between 10mg-50mg per hour depending on patient needs and the treatment algorithm. Prior to the start of the infusion, the patient may receive Versed (Midazolam) for mild sedation. The entire infusion lasts 4 hours.

We recommend a close friend or a family member to accompany the patient during their infusion to ensure comfort. However, a nurse will always be available to assist during the infusion.

The infusions can be spaced out weekly or monthly depending on individual patient needs.

Side Effects:

At higher doses (for sedation and anesthesia) Ketamine can produce unpleasant side effects like hallucinations and panic attacks, drooling and fast heart rate. To manage unpleasant experiences we supplement our infusions with small dose of Versed (Midazolam) to relax the patient and decrease the likelihood of remembering these side effects if they were to occur.

Insurance Coverage:

Typically these are cash procedures, since many insurance companies deem these to be “investigational treatments”, despite the plethora of evidence in favor of ketamine in the literature. Prices range $700 – $1200 per infusion depending on individualized treatment plan.