Palliative care 2017

More & better treatment…?

“total analgesia” for refractory pain

(different from “anesthesia”)

is defined as a state of minimal / absent pain perception in the face of a potent neuropathic or nociceptive pain stimulus without intentional alteration in awareness.

Therapeutic goal = pain relief

-not sedation, amnesia or unconsciousness.

 ketamine given in subanesthetic doses

Fine PG. Low-dose ketamine in the management of opioid non responsive terminal cancer pain. J Pain and Symptom Manage 1999; 17: 296 –300.