What is a ketamine infusion and what is it used for?
Ketamine is an old anesthetic (in use since 1967) and it continues to be one of the safest general anesthetics used today. Unlike other anesthetics, ketamine works on multiple receptors simultaneously and can improve pain, mood, depression, thoughts of suicide, cognition, coping, and stress tolerance.
That makes it a great option for treating chronic pain, comorbid depression / poor motivation or energy, fibromyalgia, complex regional pain syndrome (CRPS), and other chronic pain syndromes. Researchers at Columbia University in New York are investigating ketamine as a potential treatment option for the prevention of PTSD as well.
Bloor Pain Specialists physicians continue to advance the field with research on ketamine’s effects: Article available here
Are there patient for whom ketamine is dangerous?
No medication is 100% safe. Even too much oxygen or too much water can be toxic to us. That’s why it’s important that an anesthesiologist trained in administering ketamine be present to manage your infusion.
The following conditions are contraindicated for the administration of ketamine and you must let your doctors know if you have any of the following:
- alcohol intoxication
- increased spinal fluid pressure
- increased pressure in the eye
- significant uncontrolled high blood pressure
- sudden and serious symptoms of heart failure called acute decompensated heart failure
- failure of the heart to maintain adequate circulation
- decreased lung function
- abnormal liver function tests
- allergies to Ketamine or its metabolites
- patients who do not have anyone to take them home safely after the infusion.
It is worth noting that doses given for general anesthesia are sometimes 50 times higher than those given for outpatient chronic pain infusions. That means that patients are not unconscious, like they would be with a general anesthetic, but they can be disoriented and affected by the infusion for several hours or even up to a day or so in some cases. That means that each patient should have someone present to take them home safely.
What kind of doctor can perform outpatient ketamine infusions?
Ketamine is a general anesthetic in high doses after all. Hence, anesthesiologists and GP-anesthetists are typically the only physicians credentialled to administer this medication as an infusion and all anesthesiologists at Bloor Pain Specialists are very experienced with ketamine administration. In Ontario, the College of Physicians and Surgeons of Ontario (CPSO) is the regulatory body that will inspect the physician’s credentials prior to approving the physician to perform these procedures.