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Managing pain using ketamine has been common practice for decades. Since it was first synthesized in the early ‘60s, ketamine has become central to many medical procedures and treatments. Chronic pain sufferers, for instance, are one group of people that benefit immensely from the pain-relieving effects of ketamine. These include those that suffer terminal illnesses like cancers and neuropathic pain.
This article examines how ketamine helps with pain relief while conferring other benefits.
Analgesia is a medical term that refers to the inability to feel pain. Pain management is a crucial part of medical practice, enabling doctors and other medical practitioners to use different therapies and medications to achieve analgesia.
Ketamine is one such drug.
Understanding how ketamine brings about analgesia requires some basic knowledge of how the body’s nervous system works when handling sensations like pain.
The human body has numerous structures known as receptors. These tiny protein structures are found on the surfaces of many body tissues and organs. Within the body’s nervous system, these receptors are key in the processing of a message from a chemical form to an electrical one (signal transduction and transmission). These processes ensure that the brain can interpret these messages correctly.
There are several types of such crucial receptors. The main ones through which ketamine exerts its analgesic effects are N-methyl-D-aspartate (NMDA) receptors.
NMDA receptors are considered excitatory because that’s where glutamate binds. Glutamate is an excitatory neurotransmitter– a chemical substance that mediates signal transductions in the body. This means that the excitation (or activation) of NMDA receptors by glutamate is a primary event that initiates pain sensation.
Ketamine works (as an antagonist) by blocking these NMDA receptors, thus achieving analgesia. It will occupy the NMDA receptors instead of glutamate once introduced into the body, a phenomenon known as noncompetitive inhibition.
While there are other pathways through which ketamine is believed to exert its analgesic effects, this is thought to be the main one.
Pain is one of the body’s ways of protecting itself from further injury or aggravation of a disease condition. The sensation of pain becomes chronic once a particular injury or condition isn’t resolved. Typically, chronic pain results from:
– Nerve injury
-Inflammatory conditions arthritis
-Metabolic disorders like diabetes
-Autoimmune disorders like lupus
All the above sources of chronic pain result in either nociceptive or neuropathic pain. Nociceptive pain is the kind of pain resulting from chemical or physical tissue damage. Good examples include electrical and chemical burns. Neuropathic pain results from damage to sensory nerves, directly or otherwise. A typical example is someone with uncontrolled diabetes, resulting in chronic leg and foot pain.
Ketamine can help to manage all these types of chronic pain effectively.
In addition to the intravenous route, ketamine can also be administered through the mouth, skin, nose, or spinal cord as is the case during anesthesia.
It’s crucial to remember that the dosage of ketamine needed to achieve pain relief is much lower than that required for anesthesia before surgery.
Ketamine can have several unwanted effects even administered by a medical professional.
When given in low doses, ketamine doesn’t appear to produce any nasty side effects in most individuals. However, the following can be expected when administering ketamine:
-Tachycardia (an increased heart rate)
-Increased secretions in the airway, leading to an increased risk of choking
-Increased blood pressure
-Double or blurred vision
-Nausea and vomiting
-Dizziness and drowsiness
-A dream-like feeling
The above effects will usually subside. However, when there are hallucinations, unusual thoughts, or severe confusion within 24 hours of ketamine therapy, immediate medical attention should be sought.
As always, it’s advisable to speak with your primary care physician if you’re considering ketamine therapy for managing chronic pain. Ketamine can have a remarkable impact on the heart. This isn’t usually an issue in those with a healthy heart. However, those with known heart conditions need careful monitoring when taking ketamine for chronic pain due to the risk of spontaneous cardiac arrests.
The larger the ketamine dose for chronic pain management, the greater the risk of suffering its nasty side effects.
The best route for administering ketamine for chronic pain is intravenously. On average, a patient will need to have several sessions a week. This could last for up to four weeks. A typical ketamine infusion session lasts between 40 minutes and several hours.
Ultimately, you may want to consult a health professional first before considering ketamine therapy for your chronic pain. This ensures that you don’t suffer side effects that could potentially aggravate any known medical conditions.
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