Emerging Use of Low-Dose Ketamine for Pain Management Beyond the ICU.
Journal of pain & palliative care pharmacotherapy – July 20, 2025
Source: PubMed
Summary
Ketamine, traditionally for critical care, is now a powerful opioid alternative for pain management. A community hospital successfully implemented a low-dose ketamine infusion protocol on inpatient floors. This offers effective relief, especially for post operative pain, demonstrating a safe, valuable new model for broader adoption of ketamine in pain management.
Abstract
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.