KETAMINE IN ACUTE AND CHRONIC PAIN MANAGEMENT

Course overview

ACUTE AND CHRONIC PAIN REMAIN IMPORTANT HEALTH PROBLEMS BOTH IN THE UNITED STATES AND WORLDWIDE. WITH THE RISE IN THE PREVALENCE OF MANY CHRONIC DEGENERATIVE DISEASES ACROSS THE GLOBE, THE DISTRIBUTION AND ABSOLUTE NUMBERS OF PERSONS EXPERIENCING ACUTE AND CHRONIC PAIN HAVE CONTINUED TO INCREASE. AS A RESULT, PAIN MANAGEMENT HAS COME TO THE FOREFRONT OF THE PUBLIC HEALTH COMMUNITY. THE MANIFESTATION OF PAIN ITSELF TYPICALLY INVOLVES THE PERIPHERAL AND CENTRAL NERVOUS SYSTEMS. PAIN CAN CLASSIFY AS NOCICEPTIVE, NEUROPATHIC, OR NOCICPLASTIC IN ORIGIN. NOCICEPTIVE PAIN, ALSO REFERRED TO AS PHYSIOLOGIC PAIN, RESULTS FROM ACTIVATION OF PRIMARY NOCICEPTIVE AFFERENTS BY ACTUAL OR POTENTIAL TISSUE-DAMAGING STIMULI. IN NOCICEPTIVE PAIN, LARGE NERVE INTEGRITY REMAINS PRESERVED AS SENSORY RECEPTORS ARE STIMULATED WITHIN VISCERAL AND SOMATIC STRUCTURES. IN CONTRAST TO NOCICEPTIVE PAIN, NEUROPATHIC PAIN RESULTS FOR DIRECT INJURY OR DISEASE AFFECTING THE SOMATOSENSORY SYSTEM AND TENDS TO BE MORE DISABLING THAN NOCICEPTIVE PAIN. NEUROPATHIC PAIN SUBDIVIDES INTO PERIPHERAL (E.G. DIABETIC NEUROPATHY) AND CENTRAL (E.G., SPINAL CORD INJURY OR CENTRAL POSTSTROKE PAIN), WHILE NOCICEPTIVE PAIN SUBCATEGORIZES INTO SOMATIC OR VISCERAL (E.G., INFLAMMATORY BOWEL DISEASE). THIS ACTIVITY DESCRIBES THE INDICATIONS, CONTRAINDICATIONS, ADVERSE EFFECTS AND CLINICAL BENEFIT OF KETAMINE FOR THE MANAGEMENT OF ACUTE AND CHRONIC PAIN.