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KMID : 0371620020170020209
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Journal of Wonkwang Medical Science
2002 Volume.17 No. 2 p.209 ~ p.212
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The Effect of an Intravenous Ketamine Infusion on a Patient Who had suffered from Phantom Limb Pain
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Choi Deok-Hwa
Kim Jeong-Hoon
Ha Jeong-Ryang
Joo Min-Cheol
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Abstract
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Phantom limb pain is a kind of neuropathic pain which annoy patient severely for life. Postamputation pain syndromes have been described after the loss of body parts, including the nose, tongue, breast, finger, teeth, testes, penis, bladder, and anus. Because many peripheral sensory nerve synapse in the dorsal horn of the appropriate spinal cord segment. That axons that form the dorsal columns only send collaterals to the segmental apparatus; their first synapse is in the medulla, raising the possibility that abnormal activity in the dorsal column nuclei could also play a role in phantom sensation. After centralization, abnormal ephatic relays occur, patients complain of burning pain, cramping pain, proximal lancinating pain, and dullness. Now many remedies are available but a panacea dose not exit. Ketamine is an antagonist of the N-methyl-D-aspartate ( NMDA ) receptor that gas a crucial role in central sensitization. We met a 53 years old man who had suffered from phantom limb pain. He complain of tactile, stabbing, cramping, cold allodynia, paresthesia and burning pain. We tried nerve blocks two times and medicated various drugs but the outcome was not satisfactory. We tried ketamine infusion theraphy. We use PCA(Patient Controlled Analgesia) machine. Ketamine basal Infusion dose is 0.5mg/hr, bolus dose is Img, lockout interval is ten minutes. The patient injected ketamine for fifteen days. The result was excellent.
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KEYWORD
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Ketamine, phantom limb pain
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