Ketamine’s Troubled Past, Promising Future

In addition, through its action as an NMDA receptor antagonist, ketamine can also potentiate the analgesic effect of opioids, allowing lower doses of opioids. These properties are the reason there is now a growing body of evidence supporting the analgesic potential of sub-anesthetic, or low dose ketamine for acute pain in the emergency department (ED)…

The next logical question that follows is–who should receive low dose ketamine? Consider ketamine if the use of opioids is problematic — patients with opioid tolerance, opioid-induced hyperalgesia, true allergy — or if opioids are inadequate for pain control. A colleague recently shared an anecdote with me: a patient with renal colic had received ketorolac, 8 mg morphine and 4 mg of Dilaudid. Relief finally came after low dose ketamine, and the patient was able to be discharged home…

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