Articles  |   December 2019
SEE Question
Article Information
Cardiovascular Anesthesia / Central and Peripheral Nervous Systems / Pain Medicine / Pharmacology / Quality Improvement / Articles
Articles   |   December 2019
SEE Question
ASA Monitor 12 2019, Vol.83, 48-49.
ASA Monitor 12 2019, Vol.83, 48-49.
A 55-year-old woman is interested in trying ketamine for her long-standing pain symptoms. According to a recent consensus guideline on the use of ketamine for chronic pain conditions, which of the following statements is most likely true?
The use of ketamine, a mixture of S(+) and R(–) stereoisomers, has increased recently for a variety of indications, including depression as well as both acute and chronic pain. Ketamine exerts its effects via many pathways, but acts primarily as an N-methyl-D-aspartate (NMDA) noncompetitive antagonist, inhibiting excitatory neurotransmitters in the central nervous system and decreasing neuronal activity.
In 2018, the American Society of Regional Anesthesia and Pain Medicine, in collaboration with the American Academy of Pain Medicine and the American Society of Anesthesiologists, issued consensus guidelines on the use of intravenous ketamine infusions for chronic pain. They based their recommendations on an exhaustive literature review, combined with input from panel members who were chosen for their expertise in this area. Eight questions were discussed:
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