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What are Ketamine Infusions?

Ketamine infusions are a form of treatment for moderate to severe chronic pain that does not respond to other forms of conservative treatment. It involves the intravenous administration of a low dose of ketamine, a well-established dissociative anesthetic medication. Ketamine infusions may also be used for the treatment of anxiety and depression.

Indications for Ketamine Infusions

Ketamine infusions may be used in the management of a wide range of chronic painful conditions including:

  • Back pain
  • Fibromyalgia
  • Neuropathic pain
  • Complex regional pain syndrome
  • Cancer-related pain
  • Postherpetic neuralgia
  • Sickle cell disease
  • Phantom pain (a pain that feels like it originates from a body part or limb that has been amputated)
  • Migraines 

Contraindications for Ketamine Infusions

Ketamine infusion therapy may not be recommended for patients with:

  • High blood pressure
  • Fast heart rate
  • History of seizures 
  • Some types of head injuries 

How Ketamine Works for Pain Management

The mechanism of action of ketamine for pain control includes: 

  • Blocking the action of N-methyl-D-aspartate (NMDA), a receptor present in the nerve and brain cells, which is partly responsible for the processing of sensory input in the central nervous system.
  • Binding opioid receptors in the spinal cord and brain stem and other receptors that transmit pain signals.
  • Effecting the movement of calcium and magnesium across cell membranes in brain tissue.

Preparing for Ketamine Infusion

An initial consultation will be performed during which your doctor will go over your medical history to determine if you are a candidate for ketamine infusion. Personalized instructions will be provided at that time. In general, you may be asked to: 

  • Avoid food and drink from midnight the day before you receive treatment.
  • Temporarily discontinue some of the medications you take.
  • Bring a family member or friend who can stay with you during the therapy session and drive you home afterward.

Ketamine Infusion Procedure

Ketamine infusion procedure involves the following steps:

  • The procedure is performed with you seated comfortably in the infusion chair.
  • The access site on your arm will be cleaned with a sterile solution.
  • Your doctor or trained medical staff will insert a needle connected to your ketamine IV bag into a vein in your arm.
  • As the ketamine is slowly infused into your bloodstream, you may feel a deep sense of relaxation followed by mild euphoria and lifting of mood.
  • Your vital signs including breathing, heart rate, and oxygen saturation are constantly monitored throughout the procedure.
  • The length of the infusion process will depend on the type and severity of your pain and may vary from 45 minutes to a few hours.

Recovery after Ketamine Infusion

After the ketamine infusion ends, you will spend about an hour’s time in the recovery room to ensure there are no side effects from the treatment. You can then be driven home by your friend or family member. You may experience pain relief after the treatment; however, you should relax for the rest of the day and return to work or routine activities on the following day.

Risks and Complications of Ketamine Infusions

Ketamine infusion therapy is safe for most patients when administered in a carefully monitored setting. However, there are possible risks that include: 

  • Addiction
  • Increased blood pressure
  • Respiratory difficulty 
  • Hallucinations
  • Seizures