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Updated: Aug 5, 2026
Knee Arthrocentesis in Adults
Published on: February 25, 2022
Long-Term Effectiveness of Repeated, Single-Day Intravenous Ketamine Infusions for Severe Arthritis: A Retrospective
Leonardo Kapural1, Ishan Viradia2, Sofia Korunda2
1Carolinas Pain Institute, Winston Salem, NC.
Background:
Ketamine, either adminstered as an infusion or orally as an analgesic, was considered only to be a drug for neuropathic pain. More recently it has been speculated to be efficacious for other types of pain, including nociceptive pain.
Objectives:
We aimed to examine the long-term effects of single-day ketamine infusions for treating diffuse chronic pain caused by rheumatoid arthritis, osteoarthritis, or psoriatic arthritis.
Study Design:
Our study analyzed the records of a cohort of 38 consecutive patients treated with repeated single-day intravenous ketamine infusions for chronic arthritis pain.
Setting:
Outpatient private practice.
Methods:
Outcome data on patients treated from January 2019 through December of 2024 in our clinic were collected from our electronic medical records and analyzed. It included numeric pain scores and opioid usage. All procedures were completed under conscious sedation using a vitals monitoring protocol. Ketamine was administered at about 1-1.5 mg/kg/h during a 3 hour session. The sessions were repeated as needed at approximately every 3-12 months (median 6 months). Dosing was decided based on a patient's comorbidities. Patients with advanced cardiovascular issues, sleep apnea, or a history of substance abuse were not considered for an infusion.
Results:
A total of 38 patients-35 women and 3 men, aged from 21-73 years (median 58) with a median body mass index (BMI [kg/m2]) of 33 received repeated ketamine infusions (300-500 mg per session) for control of their chronic arthritis pain. They averaged 3 sources of chronic pain in their body. Of the 38 study patients, 18 were on opioids with a median morphine milligram equivalent of 45. Their baseline pain score was 8 and decreased at 3 months follow-up to 4 which was maintained at 4 at 24 months. Nineteen patients had more than 50% pain relief at 3 months and 20 patients at 24 months. Pain relief was maintained through 24 months after the initial infusion. Eight patients received minimal or no benefit from infusions. The number of patients on opioids decreased from 18 to 10 at 24 months with a median morphine milligram equivalent of 30.
Limitations:
This was a retrospective study.
Conclusions:
Ketamine infusion provided substantial and lasting pain relief in the majority of patients with arthritis. Repeated ketamine infusions provided consistent pain relief throughout 24 months. Opioid usage somewhat decreased in those patients on opioid medications.