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Use of Ketamine for Pain Management in Hospice Care

Use of Ketamine for Pain Management in Hospice Care

Pain is a common complication in hospice care, causing significant physical discomfort for patients receiving care for life-limiting conditions. Typically, patients receive various medications to help quell pain and keep them comfortable. When pain is severe, opioid medications often are administered to effectively manage pain.

However, sometimes, even escalating doses of opioids aren’t enough to control certain types of difficult to treat (refractory) pain. In some instances, the patient's pain initially responds to opioids, but no longer responds fully, leaving the patient in pain. 

At Integrated Spine and Pain Care, board-certified interventional pain management specialist Mikael Sarij, MD, is committed to finding solutions to managing pain. Dr. Sarij offers future-forward treatments, including ketamine infusions, which have various applications. Ketamine can treat refractory pain and keep patients in palliative care comfortable. 

Ketamine overview

Originally developed in the 1960s, ketamine is an anesthetic agent that blocks certain receptors in the brain involved in awareness, memory, and pain perception. While high doses produce general anesthesia by temporarily “switching off” the brain, lower doses of ketamine allow patients to remain awake and responsive while producing a pain-blocking effect. 

Pain management in hospice care

The goal of hospice care is to provide compassion, care, and comfort for patients with terminal illnesses. While some patients have no pain, and others may have pain that responds to conventional pain medication, some patients may experience pain that does not respond to traditional pain medication alone. 

Keeping patients comfortable is the No. 1 priority of hospice care. Patients in palliative care need significant care, physical comfort, emotional and spiritual needs, and practical tasks. Dealing with unremitting pain significantly impacts a patient’s physical comfort. 

For many patients, the typical regimen of anticonvulsants, gabapentinoids, antidepressants, and opioids is effective at managing pain well. However, when pain persists despite the typical pain management regimen, other options are available. 

Ketamine eases difficult to treat pain

Ketamine is an effective option for hospice patients who have pain that fails to respond to traditional pain management approaches. It is particularly useful for the treatment of neuropathic pain and is the most potent NMDA-receptor channel blocker available for clinical use.

The World Health Organization considers ketamine an essential medication for managing pain that doesn’t respond to typical pain medication. Ketamine appears to be synergistic with opioids in patients whose pain no longer responds to higher doses of those drugs. 

In addition to relieving pain, ketamine is shown to relieve anxiety in palliative care patients. 

It can help ease pain and reduce the need for opioid medication. Dr. Sarij carefully evaluates patients for refractory pain and works closely with the patient’s care team using a carefully composed pain management protocol.

Exceptional pain management care

All patients in hospice deserve compassionate care and to remain comfortable and as pain-free as possible. Dr. Sarij offers ketamine infusions as a specialized pain management service and takes the utmost care to incrementally increase the infusion rate until the patient is comfortable. 

To learn more about our ketamine infusion services, call one of our clinics — in Farmingdale or Deer Park, New York — or book online to schedule a consultation with Dr. Sarij today. 

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