Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
9
pubmed:dateCreated
2002-3-20
pubmed:abstractText
A 12-year-old girl presented with head and neck pain, myoclonic movements, and decreased strength in all extremities caused by a cervical spinal tumor (glioblastoma multiforme). A partial resection of the tumor was performed. Three weeks later, she had superficial pain distributed in all dermatomes below her cervical medullary lesion. Touch (e.g., gentle hugs from relatives) and movements elicited paroxysm of intense pain. The pain was not relieved by increased doses of morphine. A test dose of ketamine (7.5 mg intravenous) provided an abrupt decrease in pain intensity, and continuous infusions of subcutaneous morphine and intravenous ketamine were started. Benzodiazepines were administered to avoid psychotomimetic effects from ketamine and to diminish myoclonic movements. The doses of analgesics and benzodiazepines were increasingly titrated (subcutaneous morphine 163-750 mg/24 hr, intravenous ketamine 36-410 mg/24 hr, subcutaneous midazolam 5-20 mg/24 hr, and intravenous diazepam 11.5-122.5 mg/24 hr) until her death 67 days after start of ketamine. She remained awake until the last day before her death. For the last 29 days of life, the pain treatment regimen was successfully continued in her home (400-km distance from the hospital). In conclusion, this case demonstrates that ketamine treatment may be effective in children with severe neuropathic pain not responsive to other analgesics. This patient also demonstrates the feasibility of long-term ketamine treatment in pediatric oncology and that such treatment can be administered in a home care setting.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Dec
pubmed:issn
1077-4114
pubmed:author
pubmed:issnType
Print
pubmed:volume
23
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
616-9
pubmed:dateRevised
2011-10-6
pubmed:meshHeading
pubmed-meshheading:11902308-Analgesia, Patient-Controlled, pubmed-meshheading:11902308-Analgesics, pubmed-meshheading:11902308-Brain Stem, pubmed-meshheading:11902308-Cervical Vertebrae, pubmed-meshheading:11902308-Child, pubmed-meshheading:11902308-Diazepam, pubmed-meshheading:11902308-Drug Resistance, pubmed-meshheading:11902308-Fatal Outcome, pubmed-meshheading:11902308-Female, pubmed-meshheading:11902308-Glioblastoma, pubmed-meshheading:11902308-Home Care Services, pubmed-meshheading:11902308-Humans, pubmed-meshheading:11902308-Hyperalgesia, pubmed-meshheading:11902308-Infratentorial Neoplasms, pubmed-meshheading:11902308-Ketamine, pubmed-meshheading:11902308-Midazolam, pubmed-meshheading:11902308-Morphine, pubmed-meshheading:11902308-Pain, Intractable, pubmed-meshheading:11902308-Palliative Care, pubmed-meshheading:11902308-Spinal Cord Neoplasms, pubmed-meshheading:11902308-Touch
pubmed:year
2001
pubmed:articleTitle
Long-term treatment with ketamine in a 12-year-old girl with severe neuropathic pain caused by a cervical spinal tumor.
pubmed:affiliation
Pain Clinic, Department of Anesthesiology, University Hospital, Trondheim, Norway. pklepsta@online.no
pubmed:publicationType
Journal Article, Case Reports