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Anybody else using ketamine for trigeminal neuralgia? I've been having great success with it.
About once a year I seem to get these extremely symptomatic TGN patients who have tried all sorts of medications and therapies with no effect and are desperate for pain relief. I'll do a ketamine infusion over 15-30 mins (0.3-0.4mg/kg) and it dramatically eradicates their symptoms 100%. I mean, totally gone. The pt's are incredibly grateful every time.
I was skeptical about ketamine infusions but actually learned the technique from a colleague of mine several years ago. He would have this pt that would check into the ER asking for him specifically every few months and request these infusions because it was the only thing that would work for him.
I had another last night and decided to try bolus therapy instead since there was a delay in getting the infusion set up. The bolus therapy worked also but wasn't as smooth as the infusion as the pt had some of that dissociative craziness going on after the sudden IV bolus but that rapidly resolved. I may try IM next time as an alternative to the infusion.
Try it out next time you have a TGN patient. I can't remember the original literature we reviewed all those years ago but I found this which is some more recent literature of the topic:
https://www.resetketamine.com/blog/2018/10/4/ketamine-treatments-for-trigeminal-neuralgia
It's become really satisfying for me as these pt's get almost instantaneous pain relief and are so grateful since nothing else has worked for them in the past.
About once a year I seem to get these extremely symptomatic TGN patients who have tried all sorts of medications and therapies with no effect and are desperate for pain relief. I'll do a ketamine infusion over 15-30 mins (0.3-0.4mg/kg) and it dramatically eradicates their symptoms 100%. I mean, totally gone. The pt's are incredibly grateful every time.
I was skeptical about ketamine infusions but actually learned the technique from a colleague of mine several years ago. He would have this pt that would check into the ER asking for him specifically every few months and request these infusions because it was the only thing that would work for him.
I had another last night and decided to try bolus therapy instead since there was a delay in getting the infusion set up. The bolus therapy worked also but wasn't as smooth as the infusion as the pt had some of that dissociative craziness going on after the sudden IV bolus but that rapidly resolved. I may try IM next time as an alternative to the infusion.
Try it out next time you have a TGN patient. I can't remember the original literature we reviewed all those years ago but I found this which is some more recent literature of the topic:
https://www.resetketamine.com/blog/2018/10/4/ketamine-treatments-for-trigeminal-neuralgia
It's become really satisfying for me as these pt's get almost instantaneous pain relief and are so grateful since nothing else has worked for them in the past.
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