Description
There has been increasing clinical interest in the role of the non-competitive N-methyl-D-aspartate (NMDA) antagonist ketamine for the management of complex pain states. In vivo and in vitro studies increasingly suggest involvement of the NMDA receptor complex in a variety of chronic pain states associated with the clinical features of allodynia, central hypersensitivity and plasticity. This article explores the evidence for the role of the NMDA receptor complex in acute and chronic pain, and for the therapeutic use of NMDA receptor antagonists such as ketamine. It concludes with a discussion of the adverse effects of ketamine and some recommendations for its clinical use.
