Ketamine combined with morphine for the management of cancer pain in a patient with meperidine tolerance and addictionSuna Akın Takmaz1, Nurten İnan1, Solmaz Günal1, Çetin Kaymak1, Melike Sakallı1, Bayazit Dikmen2
1Ministry of Health Ankara Training and Research Hospital, Anesthesiology and Reanimation Department, Ankara, Turkey
2Ministry of Health, Numune Training and Research Hospital, Anesthesiology and Reanimation Department, Ankara, Turkey
Pain treatment of patients with opioid addiction and tolerance may be challenging due to their unexpectedly higher pain sensitivities and opioid requirements. It has been reported that the N-methyl-D-aspartate receptor is involved in mechanisms of tolerance to opioid analgesics. Recently enhancement of morphine induced analgesia by low dose ketamine addition to the treatment regimen has been reported. We report a cancer patient with meperidine tolerance and psychological dependency to the agent who was afterwards successfully treated with morphine-ketamine combination.
Suna Akın Takmaz, Nurten İnan, Solmaz Günal, Çetin Kaymak, Melike Sakallı, Bayazit Dikmen. Ketamine combined with morphine for the management of cancer pain in a patient with meperidine tolerance and addiction. Ağrı. 2005; 17(3): 44-47