Ketamine-fentanyl-midazolam infusion for the control of symptoms in terminal life care

Ketamine-fentanyl-midazolam infusion for the control of symptoms in terminal life care

Berger JM; Ryan A; Vadivelu N; Merriam P; Rever L; Harrison P

The American Journal Of Hospice & Palliative Care

2000

Female; Humans; Male; Pain Measurement; Aged; Middle Aged; Treatment Outcome; Drug Therapy; 80 and over; Biomarkers of Pain; retrospective studies; Infusions; Intravenous; Neoplasms/complications; Receptors; Pain/diagnosis/drug therapy/etiology; Terminal Care/methods; Combination; N-Methyl-D-Aspartate/antagonists & inhibitors; Analgesics/pharmacology/therapeutic use; Cognition Disorders/drug therapy/etiology; Fentanyl/pharmacology/therapeutic use; Hypnotics and Sedatives/pharmacology/therapeutic use; Ketamine/pharmacology/therapeutic use; Midazolam/pharmacology/therapeutic use; Psychomotor Agitation/drug therapy/etiology

In this report, we describe nine terminally ill patients with metastatic cancer who were treated with an intravenous infusion consisting of ketamine (2 mg/ml)/fentanyl (5 micrograms/ml)/midazolam (0.1 mg/ml) (K/F/M) to control pain after traditional analgesic therapies were unsuccessful. In addition to pain, all patients exhibited some symptoms of cognitive compromise and agitation. After initiation of the K/F/M infusion, all patients exhibited some degree of qualitative improvement in these symptoms as well as in overall pain control. We feel that these observations warrant reporting of the efficacy of this infusion for the treatment of uncontrolled pain and agitation in terminally ill patients when the traditional methods of pain control are inadequate.

2000

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