Palliative care 2017

More & better treatment…?

In practice

 ketamine , administered in subanesthetic doses

An IV or SC continuous infusion is initiated at a rate determined by the total dose and duration of effect of bolus doses .

For example, if sufficient pain relief for 15 min with 5 mg of ketamine,  infusion of 20 mg/h would be appropriate.

In patients receiving large-dose opioids, it is often possible (& desirable) to immediately reduce the opioid by 25%–50% Typical effects of anesthetic doses of ketamine do not pose problems when given in subanesthetic doses

(e.g., salivation, sedation, loss of airway reflexes, and hallucinations)