Ketamine treatment for intractable pain in a patient with severe refractory complex regional pain syndrome: A case report

Peyman Shirani, Alicia R. Salamone, Paul E. Schulz, Everton A. Edmondson

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

In this case report, we describe the effect of ketamine infusion in a case of severe refractory complex regional pain syndrome I (CRPS I). The patient was initially diagnosed with CRPS I in her right upper extremity. Over the next 6 years, CRPS was consecutively diagnosed in her thoracic region, left upper extremity, and both lower extremities. The severity of her pain, combined with the extensive areas afflicted by CRPS, caused traumatic emotional problems for this patient. Conventional treatments, including anticonvulsants, bisphosphonates, oral steroids and opioids, topical creams, dorsal column spinal cord stimulation, spinal morphine infusion, sympathetic ganglion block, and sympathectomy, failed to provide long-term relief from pain. An N-methyl-d-aspartate (NMDA) antagonist inhibitor, ketamine, was recently suggested to be effective at resolving intractable pain. The patient was then given several infusions of intravenous ketamine. After the third infusion, the edema, discoloration, and temperature of the affected areas normalized. The patient became completely pain-free. At one-year of follow-up, the patient reported that she has not experienced any pain since the last ketamine infusion.

Original languageEnglish (US)
Pages (from-to)339-342
Number of pages4
JournalPain Physician
Volume11
Issue number3
StatePublished - May 2008

Keywords

  • Complex Regional Pain Syndrome (CRPS)
  • Ketamine
  • Treatment

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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