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Ketamine subcutaneous continuous infusion for non-cancer neuropathic pain at home: a case report
  1. Miguel Julião1,
  2. João Ulrich1,
  3. Patrícia Calaveiras1,
  4. Elisabeth Costa1,
  5. Isabel Lucas2 and
  6. Paulo Faria de Sousa1
  1. 1Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, ACES Sintra, Sintra, Portugal
  2. 2Equipa Comunitária de Suporte em Cuidados Paliativos Ametista, ACES Alentejo Central, Alentejo, Portugal
  1. Correspondence to Professor Miguel Julião, Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, ACES Sintra, Sintra, Portugal; migueljuliao{at}gmail.com

Abstract

Objective Ketamine is a drug that can effectively treat neuropathic pain by blocking the N-methyl-D-aspartate receptor. It has been studied as a supplement to opioids for cancer pain, but its effectiveness for non-cancer pain is still limited. However, despite its usefulness in managing refractory pain, ketamine is not commonly used for home-based palliative care.

Methods A case report of a patient with severe central neuropathic pain who was treated with a subcutaneous continuous infusion of morphine and ketamine at home.

Results The introduction of ketamine in the patient’s treatment plan effectively controlled pain. Only one possible ketamine side effect was observed and easily treated with pharmacological and non-pharmacological measures.

Conclusions We have found success in using subcutaneous continuous infusion of morphine and ketamine to alleviate severe neuropathic pain in a home setting. We also observed a positive impact on the patient’s family members' personal, emotional and relational well-being after ketamine was introduced.

  • drug administration
  • family management
  • pain
  • quality of life
  • supportive care

http://dx.doi.org/10.1136/spcare-2023-004437

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    Footnotes

    • Twitter @juliaom13

    • Contributors MJ, PC and EC contributed to the study conception. Data collection and analysis were performed by all authors. The first draft of the manuscript was written by MJ and JU, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.