Ketamine Infusions for Treatment of Chronic Pain | Oregon

Ketamine: An Overview

Ketamine is a dissociative anesthetic developed in the 1960s and primarily used in surgical settings. It works by blocking the N-methyl-D-aspartate (NMDA) receptor, which is involved in pain signaling and modulation. By inhibiting these receptors, ketamine can reduce pain perception and provide relief. Additionally, ketamine has anti-inflammatory properties and influences opioid receptors, further contributing to its analgesic effects.

Mechanism of Action

Ketamine's primary mechanism in the Treatment of Chromic Pain involves the NMDA receptor antagonism. Chronic pain often leads to central sensitization, where the nervous system becomes hyper-responsive to stimuli. NMDA receptors play a crucial role in this process by facilitating excitatory neurotransmission. By blocking these receptors, ketamine helps to prevent and reverse central sensitization, thereby reducing pain.

Moreover, ketamine induces a state of dissociation, where patients experience a sense of detachment from their pain, which can be beneficial in managing chronic pain conditions. It also interacts with opioid receptors and enhances the release of endogenous opioids, providing additional pain relief.

Clinical Applications

1. Neuropathic Pain: Ketamine has shown effectiveness in treating various types of neuropathic pain, including trigeminal neuralgia, diabetic neuropathy, postherpetic neuralgia, and complex regional pain syndrome (CRPS). Studies have reported significant pain reduction in patients receiving ketamine infusions compared to placebo.
2. Fibromyalgia: Patients with fibromyalgia, a condition characterized by widespread musculoskeletal pain, have reported improvements in pain and quality of life following ketamine infusions. The therapy helps reduce hyperalgesia and allodynia associated with the condition.
3. Cancer Pain: Ketamine infusions are used as an adjunct to opioid therapy in managing refractory cancer pain. It helps enhance the analgesic effects of opioids and allows for lower doses, reducing the risk of opioid-related side effects.
4. Migraine and Cluster Headaches: Chronic migraine and cluster headache sufferers have found relief with ketamine infusions. The treatment reduces the frequency and severity of headache episodes, likely due to its effects on pain pathways and anti-inflammatory properties.
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