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Pain relief by ketamine

  • S. Himmelseher
  • E. Kochs
Conference paper

Abstract

Although advances in techniques for anaesthesia, surgery, and the protection of organs have resulted in reductions in age- and risk-adjusted mortality and morbidity, the incidence of perioperative pain has changed little over the past years. Given the increasing numbers of elderly people with age-related painful conditions and the improvements in the management of cancer with increased life expectancy, there is a large clinical need for successful perioperative pain treatment [1]. Because clinical efforts for pain therapy are currently being re-directed from empirical strategies to more targeted mechanistic approaches [2], ketamine has increasingly been used for treatment of acute and chronic pain in the perioperative setting [3, 4]. This development has been caused partly by enhanced knowledge of pathophysiological mechanisms that operate in pain pathways, where the importance of the activation of excitatory glutamate receptors of the N-methyl-d-aspartate (NMDA) subtype in nociceptive transmission, synaptic plasticity and pain sensitisation has been established for humans [5]. Ketamine binds non-competitively to the phencyclidine-binding site of the NMDA receptor channel [6]. When clinically used at subanaesthetic doses, the drug’s analgesic efficacy correlates well with its inhibiting action on NMDA receptor-mediated pain facilitation [7, 8]. The clinical relevance of ketamine effects on other potential pain control mechanisms is not yet apparent.

Keywords

Postoperative Analgesia Pain Therapy Preemptive Analgesia Caudal Analgesia Epidural Ketamine 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Italia, Milano 2004

Authors and Affiliations

  • S. Himmelseher
  • E. Kochs

There are no affiliations available

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