Korean J Pain.  2007 Dec;20(2):190-194. 10.3344/kjp.2007.20.2.190.

Pain Management via a Subcutaneous Infusion of Ketamine in a Patient with Complex Regional Pain Syndrome: A case report

• Suh JH
• Koo MS
• Nahm FS
• Shin HY
• Choi YM
• Jo JY
• Lee SC
• Kim YC

• KMID: 2278064
• DOI: http://doi.org/10.3344/kjp.2007.20.2.190

Abstract

Complex regional pain syndrome (CRPS), which is a syndrome that is defined by pain and sudomotor and/or vasomotor instability, is usually resistant to conventional treatment. Here, a case involving a 30-year-old male patient with CRPS type I who showed severe intractable right shoulder pain with allodynia and hyperalgesia despite being treated with oral medications, nerve blocks including thoracic sympathetic neurolysis, and spinal cord stimulation is described. The patient frequently visited the emergency room due to severe uncontrollable breakthrough pain. Although a favorable effect was observed in response to intermittent ketamine infusion therapies that were performed on an outpatient basis, acute exacerbation of pain occurred frequently during the night and could not be controlled. Therefore, subcutaneous ketamine infusion therapy using a patient-controlled analgesic system was attempted and found to effectively control acute exacerbation of pain during 6 weeks of infusion without serious complications.

Keyword

complex regional pain syndrome; ketamine; subcutaneous infusion

MeSH Terms

Adult
Breakthrough Pain
Emergency Service, Hospital
Humans
Hyperalgesia
Infusions, Subcutaneous*
Ketamine*
Male
Nerve Block
Outpatients
Pain Management*
Shoulder Pain
Spinal Cord Stimulation
Ketamine