Category: Federal Forum Posters
Purpose: Many patients suffering from pain or depression are inadequately managed by conventional therapies. Recently, consensus guidelines were published describing ketamine use in these conditions where patients had failed prior treatments. In the last year, five patients at Crownpoint Healthcare Facility received infusions of ketamine for chronic pain and depression according to the Crownpoint Service Unit (CPSU) ketamine administration policy and procedures. In continuing to implement this protocol, the goal is to determine the feasibility, effectiveness, and patient acceptance of intravenous ketamine infusion in an underserved Native American population with regard to an emerging alternative treatment for chronic pain and depression.
Methods: Emerging data suggest that sub-anesthetic doses of ketamine may provide rapid and robust antidepressant effects in patients with chronic pain, mood, and anxiety disorders. Non-pregnant adult patients admitted to the inpatient ward at CPSU with an active diagnosis of depression, anxiety, or chronic pain who failed at least two conventional therapies will be eligible for IV ketamine administration. Prior to ketamine infusion, informed consent will be obtained. Patients with depression and anxiety will receive ketamine 0.5mg/kg IV infused over 40 minutes. Patients with chronic pain will receive ketamine 0.1-0.5mg/kg slow IV push over a minimum of 2 minutes (maximum dose 50mg). Vital signs and presence of nausea, vomiting, headaches, agitation, psychomimetic effects, and sedation will be monitored. Benzodiazepines and antihypertensives will be immediately available to treat agitation, psychomimetic effects, and elevated blood pressure. Pre-and post-treatment patients will be assessed on their pain, anxiety and/or depression using the Numeric Pain Rating Scale, Generalized Anxiety Disorder-7 and Patient Health Questionnaire-9. Guidelines supporting these uses of ketamine will be presented to the Crownpoint medical staff. This study will be submitted to the Crownpoint Executive Board for approval.
Results: Not applicable
Conclusion: Not Applicable
Charles Matli– Pharmacy Resident, Crownpoint Healthcare Facility, Crownpoint, NM