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Ketamine infusion for chronic pain. Does it help?

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4 years 2 months ago #19746 by grappers
grappers replied the topic: Ketamine infusion for chronic pain. Does it help?
The only experience with ketamine for me was my last surgery, a high dose to knock me out, felt it go all the way up my arm it was so cold and then nothing, on waking I did have a hallucination on coming to, it was so strange, it was the first time I have ever had one from being put under, but we are talking a higher dose over a short period.

Don

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4 years 2 months ago #19783 by wormwoodbush
wormwoodbush replied the topic: Ketamine infusion for chronic pain. Does it help?
Hi gentlegiant, I agree 110% with you (mathematically impossible I know, but you know what I mean), that going in with eyes wide open is the only way to go, I encourage everyone to get as much verbal and printed info from their pain doc as they can before deciding on anything. I strongly discourage everyone (patients and friends alike) from doing internet research as Dr Google can scare the shite out of people. Only 37% of all health info on the net is accurate, meaning a whopping 63% is utter and complete garbage. That statistic comes from the Australian nursing journal Feb 2013 edn (don't ask for page number lol). I wish I'd not thrown that journal out, cause that info is priceless when telling people not to use Dr Google or don't trust Dr Google and then try and argue with your treating health practitioners! Don't know about you, but I've had it up to the eye balls with patients who say "but I read on the internet that...........(insert any one of a million illness related falsehoods here)". As for adverse reactions to ketamine, perhaps the difference between what we've encountered is related to the different administration routes? We only do subcutaneous, whereas you mentioned intravenous, it's possible. Re hypertension being the reaction I've seen the most, honestly I've only seen it 3x and one of them was me lol. I had one who's BP only rose when she sat up while on ketamine, didn't happen once the infusion stopped, so I used to just make her lie down for her obs. My BP was only up during the day and it could be attributed to the stress the idiot frustrating graduate nurses put me through!!! My second infusion was done post op and at a different hospital and my BP seemed pretty stable that time. So who knows. The only other reactions I've seen were text book reactions in a patient who was a known malingerer and liar and I unfortunately lead her to believe I'd administered a largish bolus while resetting the machine as the syringe had dislodged (i did not do a bolus, but the machine made a noise like i had, so i chose wrongly not to correct her from what she thought I'd done) and because EVERY time anyone entered her room she'd claim to be in 10/10 pain and whimper and ask for more drugs, we used to not check her infusion hourly, we'd often leave it several hours. So the infusion was 3 hours behind. When I say she was a known liar, if you observed her without her knowing you were there, she was as agile as young person should be, she'd twist and reach around for objects and the like, yet once you made your presence known, she'd instantly hunch her shoulders and pretend not to be able to reach objects right in front of her and she'd start whimpering and telling you the pain was unbearable. So she made herself quite unpopular. The day I lead her to believe she'd had a bolus, she started to complain of tingling lips and numbness of the limbs and feeling ants crawling on her skin and almost every other textbook ketamine reaction there is. I seriously doubted she genuinely had any of the symptoms, but we had to treat her as if it were true and the doc had to come in and review her in the middle of the night (the time it happened). It was all fun and games that night. Even funnier was her face when I apologised and filled her in on the truth!!! Anyway I've written a novel so I'll stop now lol.

Ros the crazy night nurse lol
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4 years 2 months ago #19784 by gentlegiant1949
gentlegiant1949 replied the topic: Ketamine infusion for chronic pain. Does it help?
Oh I had also forgotten about the swelling and redness when they removed the cups from the injection site off my chest, I had an infusion pump and it was hung around my neck. Do you subscribe to the free Issues of the Australian Prescriber? you can submit your details online through www.nps.org.au , ita great to keep up todate on the newest meds. As I said before, everyone experiences different side effects, some experience no side effects. What I always suggest to patients is for them to write down a list of questions prior to their consultation with their GP/PM Physician. And yes Google isn't totally accurate its only as good as the person who submits the infomation, although its a good guide for anyone with no medical experience. BE GUIDED by your treating physicians!

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4 years 2 months ago #19785 by Mary
Mary replied the topic: Ketamine infusion for chronic pain. Does it help?
Googling is fine as long as you stick with sites that end in either .edu or .gov. These sites have evidenced based articles, studies etc. There are also some very good . org sites, but treat them with a bit of caution because over the last few years a few commercial bodies have crept in to some of them. Generally they are reliable.

Mary

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4 years 2 weeks ago #20323 by wormwoodbush
wormwoodbush replied the topic: Ketamine infusion for chronic pain. Does it help?
Regarding the hypertension, I recently had my gall bladder out, about 3 weeks ago. I was put on IV ketamine post op and my blood pressure was quite elevated up until they removed the infusion. On the machines it read 200/110, manually, it was always around 140 -150/90 -95. The anomaly between the machine and manual was because I have very fat arms and they weren't using the correct cuff size. I know this as the night nurse (the smartest one of the lot of them) always got the bigger cuff and my readings were always around the same as the manual readings. My BP usually sits at 110/70. I was in considerable pain as I spent a week recovering from severe pancreatitis before they would operate to remove my gall bladder. But even the incredible pain didn't push my BP as high as the ketamine did. Although I wish they'd given me ketamine pre op as I had the worst time trying to get acute surgical nurses to understand that I take high doses of opioids at home and the low doses of initially injectable morphine, then endone, just weren't cutting it! I finally got some action when I fell to pieces in front of the acute pain team docs, they then wrote up much higher doses of meds, but the bloody nurses wouldn't give me the written doses, they always gave me less than was written on the chart. I finally did my block at the nurses and said I was sick of trying to explain myself and that I demand they follow the acute pain teams recommendations and administer the prescribed doses. I didn't want to be difficult, but I was in agony, 9/10 pain all the time! After that I only had to reeducation the odd one or two staff. Like when they'd bring me 2 endone instead of 4, i'd say something. Anyway that's my recent experience. Ciao for now

Ros the crazy night nurse lol

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4 years 2 weeks ago #20324 by wormwoodbush
wormwoodbush replied the topic: Ketamine infusion for chronic pain. Does it help?
I'd actually disagree with you and say Google is NOT a good guide for those with no medical experience. i find it quite the exact opposite. I've encountered it over and over, people wanting to try what they read online as an alternative to standard practice, who detriment their health because of some garbage they read online. I repeat my statistics that only 37% of all health info on the internet is accurate! 37%!!! It's not much is it? Had a woman with a fractured tibial plateau, who was in a leg splint awaiting surgery, but she was refusing surgery as she'd read about "all the people that die under anaesthetic" and she'd also read that you can heal a fractured tibial plateau with conservative management. This might have been ok in someone young with healthy bones and only one break, but she'd shattered hers and just wouldn't listen. After 8week's in rehab and missing out on Christmas at home with the family, and absolutely no progress in the healing of her breaks, she finally took us seriously and had the surgery. She came back to us post op for rehab and was on her feet and out in 5 days!!! That's just one story, I have hundreds! People with absolutely no medical knowledge at all, I think, should be strongly discouraged from using Google to research health issues. They should use resources like nurse on call, or their GP, or friends who are nurses or doctors. The internet almost always leads the naive up the wrong path and scares them with ridiculous info and horror stories.

Ros the crazy night nurse lol

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