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Macau Periodical Index (澳門期刊論文索引)
- Author
- Yung, Wai Tan; Sham, Man Kwong
- Title
- Pain management with oral ketamine in patients with advanced cancer
- Journal Name
- 澳門醫學雜誌
- Pub. Info
- 2005年6月26日, Vol.5, No.2, pp. 116-118
- Keyword
- Oral ketamine；Pain；Advanced cancer
- Abstract
- Abstract : The use of oral ketamine in the pain management of seven advanced cancer patients is reported. The starting dosage of oral ketamine was 45 to 160 mg/day. The causes of pain were different in these patients. Pain was controlled satisfactorily in five of the patients, at a dosage of 30 to 40 mg tid to qid. Pain was controlled in another patient after conversion to continuous subcutaneous infusion of ketamine, as the patient could not tolerate oral drugs because of intestinal obstruction. Other analgesics were used in addition to ketamine. In one patient, the dosage of morphine decreased from an equivalent oral dosage of 144 mg/day to 80 mg/day. Of the six patients maintained on oral ketamine, pain was controlled within five days in five. The remaining patient had significant improvement of his pain three days after starting oral ketamine, but died on the sixth days before his pain could be controlled. Oral ketamine was maintained in these seven patients for three to 43 days. One patient had nightmares, controlled with droperidol; another had palpitation not requiring treatment. Two patients had ketamine withdrawn because they were unable to tolerate oral drugs shortly before death. In one patient, ketamine 100 mg/day by subcutaneous infusion was substituted with oral ketamine 30 mg qid. The conversion ratio was approximately 1:1, as recommended in the literature. Paragraph Headings: 1. Introduction 2. Case Presentation 3. Discussion