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Intravenous Ketamine Infusion for Managing Chronic Postoperative Pain After Inguinal Herniorrhaphy: A Case Report.

André Luis Vieira Drumond, Lucas Nunes Bandeira de Melo, Marina Ayres Delgado

Journal of Pain & Palliative Care Pharmacotherapy April 30, 2025 DOI: 10.1080/15360288.2025.2496522 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Case report Peer reviewed
Sample size 1
Population 63-year-old male with chronic postsurgical pain after inguinal hernia repair
Intervention Ketamine
Dose 30 mg every 30 days
Topics Ketamine Esketamine
Keywords Anesthesia Central sensitization Chronic postoperative pain Ketamine therapy Postoperative complications Nmda receptor antagonists Chronic pain management Pain medicine
Citations 1
Key findings Periodic intravenous ketamine infusions (30 mg every 30 days) provided substantial pain relief, improved mobility, and enhanced functionality in a patient with refractory chronic postsurgical pain.

Abstract

Chronic postsurgical pain (CPSP) is a debilitating condition that affects up to 50% of patients after procedures like inguinal herniorrhaphy, significantly impairing quality of life. This case report describes a 63-year-old male who experienced refractory CPSP for 5 years following inguinal hernia repair. The patient reported persistent pain despite multiple pharmacological treatments, including amitriptyline, gabapentin, and codeine, as well as nerve blocks and nonpharmacological interventions like acupuncture. Periodic intravenous ketamine infusions (30 mg every 30 days) were introduced, resulting in substantial pain relief, improved mobility, and enhanced functionality. Ketamine, a noncompetitive NMDA receptor antagonist, has shown promise in modulating central sensitization in chronic pain, with minimal adverse effects at low doses. This case aligns with the 2018 consensus guidelines on ketamine use in chronic pain and contributes to the growing body of evidence supporting its efficacy in CPSP management. While this therapy demonstrated remarkable clinical benefits, further research is essential to establish optimal protocols and long-term outcomes for ketamine use in chronic postoperative pain.

Comparable studies

Other case reports and case series on ketamine, most cited first.

Study Year Design Participants
The destruction of the lower urinary tract by ketamine abuse: a new syndrome? Young recreational abusers of street-ketamine in Hong Kong referred to urology units 2008 Retrospective case series n = 59
Electroconvulsive Therapy, Ketamine, and Esketamine in a Patient with Major Depressive Disorder and Multiple Comorbidities: A Case Report over 10-year Treatment from Adolescence to Adulthood. A patient with treatment-resistant depression and comorbid generalized anxiety... 2025 Case report n = 1
Treatment of compulsive behaviour in eating disorders with intermittent ketamine infusions Chronic and treatment-resistant eating disorder patients 1998 Case series n = 15
Oral Administration of the NMDA Receptor Antagonist S-Ketamine as Add-On Therapy of Depression: A Case Series Four depressed patients taking standard antidepressants 2009 Case series n = 4
A longitudinal case series of IM ketamine for patients with severe and enduring eating disorders and comorbid treatment‐resistant depression Patients with enduring eating disorders and treatment-resistant depression 2021 Case series n = 4

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