The growing use of ketamine in pain management prompted Bosma et al., (2018) to investigate it. It is an N-methyl-d-aspartate antagonist which descends on the pain modulatory circuits in the human body. Ketamine modulates antinociception and decreases the temporal summation of pain. Bosma et al. (2018) conducted a study on patients with neuropathic pain to determine the most effective method for relieving pain. They investigated the role of ketamine infusion and found out that the mechanism of ketamine is effective in reducing refractive neuropathic pain.
An infusion of ketamine was administered to the patients suffering from chronic neuropathic pain. About 50% of the patients exhibited meaningful pain relief due to the action of ketamine. The dynamic involvement of the descending pain modulatory circuit and the amount of temporal summation of pain predicted treatment success and indicate mechanisms by which ketamine can reduce pain. Research participants selected for the study were suffering from refractory neuropathic pain (n = 30). Intravenous ketamine was administered to the patients for 6 hours a day. The therapeutic dose infused to the patients was 0.5 to 2.0 mg/kg/h. Dose adjustments were carried out on the patients when required to minimise the side effects and achieve maximal pain relief. For the mitigation of ketamine’s common side effects, dexamethasone, ondanseteron, and midazolam were administered to the patients for the mitigation of ketamine’s common side effects. The ketamine infusion was given for five days in a row, and the pain scores were recorded after a month. A validated questionnaire was used as a primary source of gathering data from research participants. A significant reduction in pain score was observed in patients. It blocks the pain sensation and makes the body relax. In addition to pain relief, it also helps in combating depression when used in smaller doses.
Bosma, R. L., Cheng, J. C., Rogachov, A., Kim, J. A., Hemington, K. S., Osborne, N. R., … & Davis, K. D. (2018). Brain dynamics and temporal summation of pain predicts neuropathic pain relief from ketamine infusion. Anesthesiology, 129(5), 1015-1024. https://doi.org/10.1097/ALN.0000000000002417