KETAMINE AS AN ADJUNCT TO MORPHINE IN THE TREATMENT OF PAIN

A double-blind multidose trial of the addition of ketamine (0-40 mg, i .m., 8 times per day) to intramuscular morphine therapy was undertaken in a 61-year-old man with chronic back pain related to osteoporosis w ho had received inadequate pain relief from anterior interbody fusion, dorsal column stimulation and morphine alone. The patient reported on ly mild side effects. Nausea, tiredness and well-being were not signif icantly influenced by the ketamine dose level. Visual analogue pain sc ores prior to each dose were not associated with the ketamine dose lev el, but pain scores 30 min after doses were significantly reduced in a dose-related manner. In addition, the amount of morphine used by the patient was significantly reduced as the ketamine dose increased. This patient experienced substantial benefit from the addition of ketamine to intramuscular morphine therapy.