Ketamine infusion · St. Louis

IV Ketamine Infusion for Nerve Pain in St. Louis

We give IV ketamine infusions in St. Louis for refractory nerve pain, most often reflex sympathetic dystrophy (RSD), also called complex regional pain syndrome (CRPS). The infusion runs in a monitored chair under a physician’s direction. For most patients, though, the practice now starts with sublingual or intranasal ketamine, and IV is the route chosen less often.

Why ketamine for nerve pain?

Pain that keeps firing teaches the spinal cord to amplify it. Repeated signaling drives glutamate onto NMDA receptors, the response gets louder each time, and eventually light touch reads as injury. Ketamine blocks the NMDA receptor. It turns down the amplifier rather than numbing the wire, which is why it can help pain that ordinary painkillers barely touch.

Why is IV not the usual route anymore?

Dr. Padda’s own words: the practice has moved to sublingual or intranasal ketamine for nearly all patients because it is better and less risky. An infusion means hours in a chair, a driver, and more dissociation; the under-the-tongue and nasal routes avoid most of that. A compounded topical cream with ketamine, lidocaine and an anti-inflammatory is also used for CRPS skin pain. The full comparison is on the Padda Institute’s ketamine therapy page. IV infusion stays available for the patients it suits.

Who is a candidate for a ketamine infusion?

• RSD/CRPS meeting the Budapest clinical criteria, or documented nerve pain with touch sensitivity.
• Standard care tried first: nerve-calming medication, sympathetic blocks, desensitization and physical therapy.
• No medical condition that makes ketamine unsafe.

Ketamine is not a first step and not a substitute for finishing the diagnosis. It works alongside desensitization and therapy, never instead of them.

What happens during an IV ketamine infusion?

Screening comes first. During the infusion, blood pressure, pulse and oxygen are monitored throughout. Expect dissociation, vivid dreams, sedation, and sometimes nausea and a rise in blood pressure and heart rate. You cannot drive afterward; someone must take you home.

Repeated or prolonged ketamine exposure can injure the bladder and the liver, and ketamine is a Schedule III controlled substance with a risk of misuse. It is generally avoided in uncontrolled high blood pressure, unstable heart disease, raised pressure in the skull or eye, psychosis, significant liver disease, pregnancy and active substance use.

Questions patients ask

How long does a ketamine infusion take?

Plan for several hours including monitoring and recovery, and plan for a driver. See what to expect at your IV infusion.

Can I drive home after a ketamine infusion?

No. Ketamine impairs judgment and coordination for the rest of the day. Someone must drive you home. More on aftercare.

Is ketamine infusion used for depression here?

This service gives ketamine for nerve pain. Call us and we will tell you plainly what fits your case; the routes are compared on the Padda Institute ketamine page.

Is sublingual ketamine as good as an infusion?

For most patients, the practice prefers it: it is better tolerated and less risky, though controlled trial evidence is strongest for the IV route. Your physician chooses the route with you. Doctors can refer a patient here.