Ketamine is an anesthetic that has been used safely and effectively since its approval by the FDA in 1970. Within the last twenty years, researchers have shown that ketamine has other potential treatment applications in addition to anesthesia.
By stimulating neuronal growth, IV ketamine can improve mood and relieve chronic pain rapidly. Most patients who have had IV ketamine feel a significant improvement after the first treatment session. This improvement wanes over the subsequent 24-48 hours, but as the IV ketamine protocol continues, the symptom relief becomes increasingly sustained.
Although there is still a lot unknown about phantom limb pain, it is clear that PLP involves both central and peripheral neural factors that activate N-methyl-D-aspartate (NMDA) receptors. Ketamine is known to block these NMDA receptors. Because of this, IV ketamine is considered to be a potentially effective treatment for many neuropathic disorders, including PLP.
Phantom limb pain can sometimes be opioid-resistant. Ketamine offers opiate-sparing effects. It can either be used as a primary analgesic (pain reliever) or analgesic adjuvant (used after initial treatment).
If IV ketamine is indicated, the dosage is decided based on the patient’s body weight (0.5mg/kg). Each ketamine infusion lasts about 40 minutes, after which patients should have someone available to accompany them home safely. During the infusion, patients recline in a treatment chair surrounded by a calm, quiet and experientially safe environment. Ketamine is delivered at a slow and controlled dose and a registered nurse accompanies each patient for the duration of the infusion to monitor blood pressure, pulse and oxygen saturation. Patients do not experience any respiratory effects during or after the treatment.
IV Ketamine Therapy is well-tolerated. During a ketamine infusion, patients remain aware of their surroundings and experience a deep relaxation. Your clinician may lower the lights, offer an eye mask or aromatherapy, or take other measures to make the setting more comfortable.
Some patients may experience dissociation, perceptual disturbances or nausea. Generally, any changes in perception or dissociation dissipate very quickly after the infusion. However, many patients report that feelings of dissociation experienced during the infusion can help them develop an objective perspective about past experiences.
Typically, patients receive 8-12 ketamine infusions over the course of 3-4 weeks. The combination, frequency, and order of each of your treatment sessions will be discussed with you and will be recommended based on your unique circumstances.