Mateja LopuhGeneral Hospital of Jesenice, Slovenia
Title: Use of oral ketamine in palliative care
Ketamine, an N-methyl-D-Aspartate receptor antagonist, has been used for more than 50 years. From its initial potencial as an anesthetic drug, its use has increased in the fields of pain medicine, psychiatry, and palliative care. It is available in different formulations, of which oral use is promising due to its active metabolite, norketamine which reaches 2-3 times higher levels when administered orally in comparison with parenteral use. Oral use is also more feasible and easier to use in settings, where medical staff is not that present, such as home care or hospices. Oral solution of ketamine has not yet been officially licensed for use although there have been several reports which recommend its use in neuropathic pain, severe depression, airway obstruction and anxiety. Palliative care is defined as total care for patients whose disease do not respond to curative treatment. It encompasses good control of physical symptom, and psychological, social and spiritual problems. Patients often experience pain, despite high doses of opioids, depression and anxiety and dyspnea. Oral ketamine does not have the side effects of opioids therefore it represents a good alternative. It may also reduce the need for high opiod dose and be more suitable for patients who wish to avoid the necessary sedation.
Mateja Lopuh, MSc,is an anesthesiologist, subspecialized in palliative care. She is the national coordinator at the MoH of Slovenia for palliative care development. She has established a functioning palliative care network. She is a lecturer at all major conferences for palliative care in Slovenia and head of the education in Gorenjska for palliative care. She also coordinates several research projects on national basis.