Intranasal Ketamine for the Management of Incidental Pain during Wound Dressing in Cancer Patients: A Pilot Study

INTRODUCTION: Cancer wounds need regular dressing; else they develop infection, foul odor, and in extreme cases, maggots. Patients resist dressing due to the severe incidental pain during dressing. Intranasal ketamine was tried as an analgesic to reduce this incidental pain. MATERIALS AND METHODS: Twenty patients with wounds requiring regular dressing were selected; these patients had a basal pain score of 4/10 and incidental pain score of 7/10 during four consecutive dressings. Ketamine 0.5 mg/kg was administered transmucosally 10 min before dressing, and pain scores, hemodynamic parameters, and sedation were recorded for up to 2 h in six consecutive dressings. RESULTS: Ketamine produced a significant reduction in incidental pain without any hemodynamic changes or sedation. CONCLUSION: Ketamine appears to be a safe and effective analgesic when used intranasally for incidental pain.