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Intravenous Ketamine Infusions for Acute Pain Management

 From the American Society of Regional Anesthesia and Pain Medicine, the American Academy of Pain Medicine, and the American Society of Anesthesiologists

Regional Anesthesia and Pain Medicine
June 2018 - Online First
doi: 10.1097/AAP.0000000000000806

Schwenk, Eric, S., MD; Viscusi, Eugene, R., MD; Buvanendran, Asokumar, MD; Hurley, Robert, W., MD, PhD; Wasan, Ajay, D., MD, MSc; Narouze, Samer, MD, PhD; Bhatia, Anuj, MD, MBBS; Davis, Fred, N., MD; Hooten, William, M., MD; Cohen, Steven, P., MD

Ketamine infusions have been used for decades to treat acute pain, but a recent surge in usage has made the infusions a mainstay of treatment in emergency departments, in the perioperative period in individuals with refractory pain, and in opioid-tolerant patients. The widespread variability in patient selection, treatment parameters, and monitoring indicates a need for the creation of consensus guidelines. 

Consensus guidelines were prepared in the following areas: indications, contraindications for acute pain and whether they differ from those for chronic pain, the evidence for the use of ketamine as an adjunct to opioid-based therapy, the evidence supporting patient-controlled ketamine analgesia, the use of nonparenteral forms of ketamine, and the subanesthetic dosage range and whether the evidence supports those dosages for acute pain. 

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