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Lookup NU author(s): Dr Anne Pelham, Dr Felicity DewhurstORCiD, Dr Rachel Quibell
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© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.A 62-year-old man with metastatic duodenal cancer was admitted to a hospice for a trial of ketamine to manage complex neuropathic abdominal pain. The patient was incrementally established on a dose of 150 mg orally four times day with no adverse effects. Following treatment of hypomagnesaemia intravenously, the patient experienced marked symptoms of ketamine toxicity, known as a â € K-hole' amongst recreational users, following the next dose of ketamine. Ketamine and magnesium are both antagonists of the N-methyl-D-aspartate receptor, which plays a part in central sensitisation to pain. There is some evidence that correction of hypomagnesaemia may improve analgesia and that there is synergism between ketamine and magnesium in analgesia, but this relationship is poorly understood. This is the first report suggesting that blood magnesium levels may affect the side effects of a stable dose of ketamine.
Author(s): McConnell R, Pelham A, Dewhurst F, Quibell R
Publication type: Article
Publication status: Published
Journal: BMJ Supportive and Palliative Care
Year: 2021
Volume: 13
Issue: e2
Pages: e291-e293
Online publication date: 16/02/2021
Acceptance date: 07/02/2021
ISSN (print): 2045-435X
ISSN (electronic): 2045-4368
Publisher: BMJ Publishing Group
URL: https://doi.org/10.1136/bmjspcare-2021-002886
DOI: 10.1136/bmjspcare-2021-002886
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