Eesha Oza, Yashvi Rateshwar, Aneesha Santhosh, Vinnidhy Dave
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引用次数: 0
摘要
疼痛管理是医疗保健中的一个关键挑战,因为急性和慢性疼痛影响着全球数百万人。曾经被认为是传统治疗方法的阿片类药物治疗由于其局限性和风险而面临审查,因此很明显,需要一种同样有效的替代疼痛管理方法。氯胺酮是一种很有前途的解决方案。氯胺酮作为NMDA (n -甲基- d -天冬氨酸)受体拮抗剂,调节中枢和外周水平的疼痛通路,这使其能够解决阿片类药物无法充分靶向的复杂疼痛机制。对于阿片类药物难治、不耐受或标准治疗无法缓解疼痛的患者来说,这是一个有价值的选择。虽然传统上用于重症监护病房(icu),但氯胺酮的使用已扩大到我们机构的普通住院楼层。本文将以我们的经验为原型,提出一个在社区医院实施低剂量氯胺酮治疗疼痛的模型。它将强调氯胺酮的药理学优势、安全性考虑以及实施所需的工作人员教育、后勤和协作。通过在我县开创这一模式,我们的目标是为其他社区医院提供一个可借鉴的模式。
Emerging Use of Low-Dose Ketamine for Pain Management Beyond the ICU.
Pain management is a critical challenge in healthcare as acute and chronic pain affect millions of individuals globally. Opioid-based therapies that were once considered the traditional treatment methods are facing scrutiny due to their limitations and risks, due to which it is evident that an equally effective alternative pain management approach is necessary. Ketamine is a promising solution. Ketamine acts as an NMDA (N-methyl-D-aspartate) receptor antagonist, and modulates pain pathways at central and peripheral levels, which enables it to address complex pain mechanisms that opioids cannot adequately target. It is a valuable option for patients who are opioid refractory, intolerant, or have insufficient pain relief from standard therapies. While traditionally used in intensive care units (ICUs), ketamine use has been expanded to general inpatient floors at our institution. This article will present a model for implementing a low-dose ketamine protocol for pain management in a community hospital setting, using our experience as a prototype. It will highlight ketamine's pharmacological advantages, safety considerations, and the staff education, logistics, and collaboration necessary for implementation. By pioneering this model in our county, our goal is to provide a model for other community hospitals to adopt.