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Emergency Medical Minute


Sep 20, 2021

Contributor: Don Stader, MD

Educational Pearls:

  • Those on chronic opioid therapy may have high tolerance to opioids and/or opioid hyperalgesia
  • Ketamine is a good adjunct for pain control in patients on chronic opioid therapy
  • To avoid the time constraints often required to push ketamine intravenously, it can be given orally:
    • Ketamine IV 25-50 mg (~0.01-0.03 mg/kg) as a single dose by mouth


Blonk M, Koder B, et al. Use of oral ketamine in chronic pain management: A review. European Journal of Pain. 2009.

Schwenk ES, et al. Consensus guidelines on the use of intravenous ketamine infusions for acute pain management from the America Society of Regional Anesthesia and Pain Medicine, the American Academy of Pain Medicine and the American Society of Anesthesiologists. Reg Anesth Pain Med. 2018.

Summarized by John Spartz, MS4 | Edited by Erik Verzemnieks, MD


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