ProcedureInfusions & medication
Ketamine & lidocaine infusions
Infusions are not a routine treatment and are not offered on request. In carefully selected people with resistant neuropathic pain, a supervised infusion can reduce sensitisation enough to make rehabilitation possible.
What it is
A low-dose intravenous infusion of ketamine or lidocaine, given slowly with cardiac and blood pressure monitoring throughout. Both act on the mechanisms that keep the nervous system sensitised.
Who it suits
- Neuropathic pain that has not responded to adequate medication trials
- CRPS where sensitisation is blocking rehabilitation
- Cancer-related nerve pain, in coordination with your oncology team
- People who can attend for monitoring and have an escort home
On the day
A cannula is placed and the infusion is run slowly while you are monitored. You remain awake. Side effects during the infusion — light-headedness, a dreamy or detached feeling, a metallic taste — are managed by adjusting the rate.
Afterwards
You recover in clinic before going home with your escort. No driving, alcohol or important decisions for the rest of the day.
Where there is benefit, it is used as a window: the rehabilitation and medication plan is timed to start inside it.
Risks
- Nausea, dizziness or a detached feeling during and shortly after
- Transient blood pressure or heart rate change — monitored throughout
- Vivid dreams or unsettling perceptual effects with ketamine
- No benefit in a proportion of people, which is why courses are not booked in advance
A note on this page
This is general information, written to help you prepare for a conversation. It is not a substitute for an individual assessment — what is right for you depends on your history, your examination and your own goals.
Common questions
Asked before, answered here
No. This is pain-directed, at different doses and protocols, and is not a mental health treatment.
One is assessed on its own merits. Further infusions are only arranged if the first produced a measurable benefit.
—Begin
Ask whether this suits you
Suitability is decided after an assessment, never from a form. Tell us where you are up to and we will advise honestly.
Visit
Level 2, 48 Macquarie StreetSydney, NSW 2000Response
Enquiries are answered within one to two business days. Urgent clinical matters are triaged the same day by the practice team.