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Oral Ketamine for Acute Pain Management After Amputation Surgery
Asokumar Buvanendran1, Jeffrey S Kroin1, Arvind Rajagopal1
1Department of Anesthesiology, Rush University Medical Center, Chicago, Illinois, USA.
Pain Medicine (Malden, Mass.)
|October 13, 2017
Summary
This pilot study found that oral ketamine is a safe method for managing acute pain after amputation surgery. Multiple doses over three days showed no serious adverse events, suggesting potential for hospital and home use.
Area of Science:
- Anesthesiology
- Pain Management
- Pharmacology
Background:
- Intravenous ketamine is effective for postoperative analgesia and reducing opioid use.
- Limited research exists on the safety and efficacy of oral ketamine for perioperative pain management.
Purpose of the Study:
- To determine the safety of multiple-dose oral ketamine administration over a three-day perioperative period for acute pain following amputation surgery.
Main Methods:
- A pilot study involving three adult patients undergoing elective lower extremity amputation.
- Oral ketamine (1.0 mg/kg) administered preoperatively, 8 hours postoperatively, and then three times daily for two postoperative days, with a dose reduction on day two.
- Primary outcome measure was the incidence of adverse events.
Main Results:
- No serious or unexpected adverse events were reported, and no dose reductions were necessary.
- Postoperative pain scores (numerical rating scale) ranged from 0.5-4.0.
- Opioid consumption (morphine milligram equivalents) was low, ranging from 0-17.5 mg on postoperative day one and 1.0-4.0 mg on postoperative day two.
Conclusions:
- Multiple-dose oral ketamine (1 mg/kg three times daily) appears safe and convenient for managing acute postoperative pain after amputation.
- Further research is warranted to explore its potential in reducing chronic stump or phantom limb pain.