{"id":18993,"date":"2016-05-20T22:18:50","date_gmt":"2016-05-21T02:18:50","guid":{"rendered":"https:\/\/pelvicguru.com\/?p=18460"},"modified":"2024-06-18T14:57:28","modified_gmt":"2024-06-18T18:57:28","slug":"ketamine-infusion-for-pelvic-pain-what-is-it","status":"publish","type":"post","link":"https:\/\/thebetashow.com\/pelvicglobal_new\/ketamine-infusion-for-pelvic-pain-what-is-it\/","title":{"rendered":"Ketamine: Advancing the Treatment of Chronic Pain Conditions"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"18993\" class=\"elementor elementor-18993\" data-elementor-post-type=\"post\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-3358cc8a elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"3358cc8a\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-555d24f0\" data-id=\"555d24f0\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-1877602c elementor-widget__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"1877602c\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Ketamine has emerged as a transformative agent in the management of chronic pain conditions such as Complex Regional Pain Syndrome (CRPS), pelvic pain, and pudendal neuralgia. In some cases, ketamine therapies can provide relief from pain when no other treatments have worked.<\/p><p><strong>Transition from Anesthetic to Analgesic<\/strong><\/p><p><span style=\"font-weight: 400;\">Ketamine was first developed in the 1960s and was originally developed as an anesthetic and it has a long history of safe and reliable use in operating rooms and emergency rooms, and it found use in battlefield medicine and in underdeveloped countries \u2013 largely due to its effectiveness and safety profile. It remains in wide use in many settings including inpatient and outpatient surgeries, emergency medicine, and veterinary medicine.<\/span><\/p><p><span style=\"font-weight: 400;\">Over time the therapeutic potential of ketamine was recognized and studied. Ketamine has demonstrated efficacy in treating depression, anxiety, PTSD and other mood disorders and some pain conditions. Its ability to alleviate neuropathic pain, which is often resistant to other treatments, has made it a valuable asset in pain management protocols.<\/span><\/p><p><b>How Ketamine works<\/b><\/p><p><span style=\"font-weight: 400;\">As with many drugs, the exact mechanisms of ketamine in treating pain \u2013 how it works at a molecular level \u2013 are not totally understood. There is substantial and growing research in this area, however. Ketamine largely works at the level of neurons and appears to improve the function of neural pathways and transmission. Ketamine appears to re-calibrate pain pathways \u2013 effectively reducing symptoms of pain and allowing for more normalized neural function.<\/span><\/p><p><b>Targeting CRPS with Ketamine<\/b><\/p><p><span style=\"font-weight: 400;\">CRPS is a chronic and excruciating condition that typically affects a limb after an injury, surgery, stroke, or heart attack. The disproportionate pain experienced by CRPS sufferers is often resistant to standard pain medications and treatments. Studies, and my own clinical experience, has shown that ketamine infusions can often significantly reduce CRPS flares and make pain more manageable. <\/span><\/p><p><b>Addressing Pelvic Pain and Pudendal Neuralgia<\/b><\/p><p><span style=\"font-weight: 400;\">Pelvic pain and pudendal neuralgia, which impact the regions serviced by the pudendal nerve, including the genitalia and anus, can be debilitating. These syndromes often stem from nerve inflammation or dysfunction \u2013 which is where ketamine excels at providing benefits. Ketamine treatments can provide relief of pain in these cases.<\/span><\/p><p><b>Modalities of Ketamine Administration for Pain Management<\/b><\/p><p><span style=\"font-weight: 400;\">There are multiple methods or pathways to administer ketamine treatments \u2013 with benefits and drawbacks to each:<\/span><\/p><ul><li style=\"font-weight: 400;\" aria-level=\"1\"><b>IV Infusions:<\/b><span style=\"font-weight: 400;\"> This is the most common form of administration, offering quick and controlled relief \u2013 which can be especially fine-tuned when combined with a controllable pump for precise and adjustable dosing. IV infusions should only be administered by appropriate professionals.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>Sublingual, Oral and Intranasal Delivery:<\/b><span style=\"font-weight: 400;\"> These methods are often used for administration where more sophisticated delivery options may not be available. These methods should be approached with greater caution because of the potential for more uneven dosing, and even the potential to ingest a very large dose if, for instance, sublingual ketamine is accidentally swallowed.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\"><span style=\"font-size: 12pt; font-family: Calibri, sans-serif; color: #000000; background-color: transparent; font-weight: bold; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;\">Suppositories, Lotions and Topical Creams:<\/span><span style=\"font-size: 12pt; font-family: Calibri, sans-serif; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;\"> These are alternatives for those who might prefer not to have IV infusions or are looking for localized treatment options to manage symptoms more directly associated with pelvic pain, for instance.<\/span><br \/><\/span><\/li><\/ul><div><span style=\"color: #000000; font-family: Calibri, sans-serif;\"><span style=\"white-space-collapse: preserve;\">\u00a0<\/span><\/span><\/div><p><span style=\"font-size: 12pt; font-family: Calibri, sans-serif; color: #000000; background-color: transparent; font-weight: bold; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;\">Safety and Efficacy Considerations<\/span><\/p><p><span style=\"font-size: 12pt; font-family: Calibri, sans-serif; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;\">Most side effects of ketamine are transient, including dissociative experiences and nausea. There are other, more serious concerns such as changes in blood pressure, potential distress at moderate and high doses, and some other rare but possible negative outcomes from use \u2013 especially prolonged use at high doses. It is imperative that treatment be overseen by healthcare professionals with expertise in pain management, preferably anesthesiologists, who can effectively manage dosing and monitor for adverse effects.<\/span><span style=\"font-size: 12pt; font-family: Calibri, sans-serif; color: #000000; background-color: transparent; font-weight: bold; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;\"><br \/><\/span><\/p><p><span style=\"font-size: 12pt; font-family: Calibri, sans-serif; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;\">Choosing an experienced and qualified provider is crucial when considering ketamine for pain management. The provider should be well-versed in ketamine\u2019s pharmacodynamics and adept at handling its complex effects toward a safe and beneficial outcome.<\/span><span style=\"font-size: 12pt; font-family: Calibri, sans-serif; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;\"><br \/><\/span><\/p><p><span style=\"font-size: 12pt; font-family: Calibri, sans-serif; color: #000000; background-color: transparent; font-weight: bold; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;\">An Important Treatment Option<\/span><span style=\"font-size: 12pt; font-family: Calibri, sans-serif; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;\"><br \/><\/span><\/p><p><span style=\"font-size: 12pt; font-family: Calibri, sans-serif; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;\">Ketamine\u2019s promise in treating refractory cases of chronic pain such as CRPS, pelvic pain, and pudendal neuralgia represents a notable advancement in pain management. By addressing the function of neurons directly ketamine appears to uniquely help conditions where other treatment options have failed. I have seen ketamine infusion therapy significantly reduce suffering and enhances the overall quality of life for many patients. It may not be a cure, but it can be an important method of managing pain and getting back to your life.<\/span><\/p><p><span style=\"background-color: transparent; color: #000000; font-family: Calibri, sans-serif; font-size: 12pt; white-space-collapse: preserve;\">&#8211; Allison Wells, MD<\/span><\/p><p>\u00a0<\/p><p dir=\"ltr\" style=\"line-height: 1.2; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-size: 12pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: bold; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">About Dr Allison Wells<\/span><\/p><p dir=\"ltr\" style=\"line-height: 1.2; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-size: 12pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: bold; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">\u00a0<\/span><\/p><p dir=\"ltr\" style=\"line-height: 1.2; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-size: 12pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: bold; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\"><span style=\"font-weight: normal;\"><span style=\"font-size: 12pt; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-variant-position: normal; vertical-align: baseline;\">Dr Wells is an anesthesiologist and an experience-leader in ketamine treatments for mood disorders and pain conditions. She founded one of the first focused clinics in the country, has helped many patients with many thousand infusions, and actively contributes to the field with research and advocacy. Wells Medicine <a href=\"http:\/\/www.wellsmedicine.com\">wellsmedicine.com<\/a>, in Houston, TX, provides interventional procedures and a focus on comprehensive mental health toward excellence in evidence-based care.<\/span><\/span><br \/><\/span><\/p><p dir=\"ltr\" style=\"line-height: 1.2; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-size: 12pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Dr. Wells holds degrees from Swarthmore College and Baylor College of Medicine. She trained at Baylor College of Medicine and Harvard Medical School. She is a member of the American Society of Anesthesiologists, The Texas Society of Anesthesiologists and the Texas Medical Association.\u00a0<\/span><\/p><p dir=\"ltr\" style=\"line-height: 1.2; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-size: 12pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: bold; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\"><b style=\"font-weight: normal;\">\u00a0<\/b><\/span><\/p><p dir=\"ltr\" style=\"line-height: 1.2; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-size: 12pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Wells Medicine, Houston, TX<\/span><\/p><p dir=\"ltr\" style=\"line-height: 1.2; margin-top: 0pt; margin-bottom: 0pt;\">\u00a0<\/p><p dir=\"ltr\" style=\"line-height: 1.2; margin-top: 0pt; margin-bottom: 0pt;\"><a href=\"http:\/\/www.wellsmedicine.com\"><span style=\"font-size: 12pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">wellsmedicine.com<\/span><\/a><\/p><p dir=\"ltr\" style=\"line-height: 1.2; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-size: 12pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">\u00a0<\/span><\/p><p dir=\"ltr\" style=\"line-height: 1.2; margin-top: 0pt; margin-bottom: 0pt;\">\u00a0<\/p><p dir=\"ltr\" style=\"line-height: 1.2; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"background-color: transparent; color: #000000; font-family: Calibri, sans-serif; font-size: 12pt; font-weight: bold; white-space-collapse: preserve;\">Some additional information and helpful references<\/span><\/p><p dir=\"ltr\" style=\"line-height: 1.2; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"background-color: transparent; color: #000000; font-family: Calibri, sans-serif; font-size: 12pt; font-weight: bold; white-space-collapse: preserve;\">\u00a0<\/span><\/p><p dir=\"ltr\" style=\"line-height: 1.2; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-size: 12pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Health Organization for Pudendal Education. (2018). Chronic pelvic pain. Retrieved May 12, 2024, from <\/span><a style=\"text-decoration: none;\" href=\"https:\/\/www.pelvicpain.org.au\/wp-content\/uploads\/2018\/12\/HealthOrganisationforPudendChronicPainBro1_0.pdf\"><span style=\"font-size: 12pt; font-family: Calibri,sans-serif; color: #0563c1; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: underline; -webkit-text-decoration-skip: none; text-decoration-skip-ink: none; vertical-align: baseline; white-space: pre-wrap;\">https:\/\/www.pelvicpain.org.au\/wp-content\/uploads\/2018\/12\/HealthOrganisationforPudendChronicPainBro1_0.pdf<\/span><\/a><\/p><p dir=\"ltr\" style=\"line-height: 1.2; margin-top: 0pt; margin-bottom: 0pt;\"><b id=\"docs-internal-guid-57e82ab1-7fff-00b1-eb43-4486702cd1b7\" style=\"font-weight: normal;\">\u00a0<\/b><\/p><p dir=\"ltr\" style=\"line-height: 1.2; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-size: 12pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Pudendal neuralgia. Global Library of Women&#8217;s Medicine. Retrieved May 12, 2024, from <\/span><a style=\"text-decoration: none;\" href=\"https:\/\/www.glowm.com\/womens-medicine-amp.html?item=691&amp;name=pudendal-neuralgia\"><span style=\"font-size: 12pt; font-family: Calibri,sans-serif; color: #0563c1; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: underline; -webkit-text-decoration-skip: none; text-decoration-skip-ink: none; vertical-align: baseline; white-space: pre-wrap;\">https:\/\/www.glowm.com\/womens-medicine-amp.html?item=691&amp;name=pudendal-neuralgia<\/span><\/a><\/p><p dir=\"ltr\" style=\"line-height: 1.2; margin-top: 0pt; margin-bottom: 0pt;\"><b style=\"font-weight: normal;\">\u00a0<\/b><\/p><p dir=\"ltr\" style=\"line-height: 1.2; margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"font-size: 12pt; font-family: Calibri,sans-serif; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Leslie SW, Antolak S, Feloney MP, et al. Pudendal Neuralgia. [Updated 2022 Nov 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.\u00a0Available from: <\/span><a style=\"text-decoration: none;\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK562246\/\"><span style=\"font-size: 12pt; font-family: Calibri,sans-serif; color: #0563c1; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: underline; -webkit-text-decoration-skip: none; text-decoration-skip-ink: none; vertical-align: baseline; white-space: pre-wrap;\">https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK562246\/<\/span><\/a><\/p><p dir=\"ltr\" style=\"line-height: 1.2; margin-top: 0pt; margin-bottom: 0pt;\"><br \/><span style=\"font-size: 12pt; font-family: Calibri, sans-serif; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;\">Gargori NMB, Alahwal H, Vacheron CH, Alam FMA. Predictive factors of success and failure for intravenous ketamine therapy in patients suffering from chronic neuropathic pain. Saudi J Anaesth. 2023 Jul-Sep;17(3):340-348. doi: 10.4103\/sja.sja_737_22. Epub 2023 Jun 22. PMID: 37601528; PMCID: PMC10435804.\u00a0 <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/37601528\/\"><span style=\"font-size: 12pt; font-family: Calibri, sans-serif; color: #0563c1; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-variant-position: normal; text-decoration-line: underline; text-decoration-skip-ink: none; vertical-align: baseline; white-space-collapse: preserve;\">https:\/\/pubmed.ncbi.nlm.nih.gov\/37601528\/<\/span><\/a><span style=\"background-color: transparent; color: #000000; font-family: Calibri, sans-serif; font-size: 12pt; font-weight: bold; white-space-collapse: preserve;\"><br \/><\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>The topic of Ketamine infusions can elicit some strong concerns. Some clinicians are familiar with a type of infusion known as &#8220;Ketamine comas,&#8221; in which people are placed in a medical coma and stay in an ICU for treatment. This is often viewed as quite extreme, and risky; and leaves many wondering the efficacy of such a treatment when the patient is not actively participating in recovery from a brain\/pain connection. For clarification, the coma is not the only protocol available. Ketamine infusions can involve: 1. Outpatient &#8220;awake&#8221; protocol 2. Low-dose inpatient protocol 3. Ketamine coma. (In addition, there are now physicians who prescribe compounded ointments with Ketamine as one of the medications. This is not the same as an infusion. There&#8217;s not enough data at this time about efficacy and safety of this approach with topicals.) Our guest blogger, Dr. Allison Wells, MD, is sharing information about the outpatient procedure.  ~ Tracy Sher of Pelvic Guru<\/p>\n","protected":false},"author":3,"featured_media":72303,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2,3,6,7,11,18,22,25],"tags":[90,146,292,339,340,357,1489,1476,391,855,410,425,1384,428,481,1546],"class_list":["post-18993","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-all","category-bladder-painic","category-endometriosis-2","category-female-cancer-2","category-interventions-and-treatments","category-pelvic-pain-2","category-pudendal-neuralgia-2","category-sexual-pain","tag-chronic-pelvic-pain","tag-dr-allison-wells","tag-ketamine","tag-nerve-entrapment","tag-nerve-pain","tag-pain","tag-pelvic-global","tag-pelvic-global-academy","tag-pelvic-guru","tag-pelvic-guru-academy","tag-pelvic-pain","tag-pelvic-physical-therapy","tag-pelvic-physiotherapy","tag-pelvic-pt","tag-pudendal-neuralgia","tag-sacral-nerves"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.4 - 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