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The patient was successfully tapered off a total fentanyl patch dose of 162 mcg\/hour every 72 hours (morphine equivalent dose of 389\u2009mg\/day) to short-acting hydromorphone 2\u2009mg orally two times per day as needed (equivalent of 8\u2009mg morphine sustained-release twice per day) during a 2-week admission with only mild withdrawal symptoms. We discuss the pharmacology of ketamine and its possible application in the treatment of OIH.<\/jats:p>","DOI":"10.1136\/bcr-2023-255333","type":"journal-article","created":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T00:28:59Z","timestamp":1704846539000},"page":"e255333","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Continuous ketamine infusion for the management of opioid-induced hyperalgesia following amputation"],"prefix":"10.1136","volume":"17","author":[{"given":"James","family":"Cairns","sequence":"first","affiliation":[{"name":"Neurology, The University of British Columbia, Faculty of Medicine, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tanya Lei","family":"Feng","sequence":"additional","affiliation":[{"name":"Medicine, The University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"May C","family":"Ong","sequence":"additional","affiliation":[{"name":"Medicine, The University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,1,4]]},"reference":[{"key":"2025082708082736000_17.1.e255333.1","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1080\/09540261.2018.1514369","article-title":"Comorbid chronic pain and opioid use disorder: literature review and potential treatment innovations","volume":"30","author":"Speed","year":"2018","journal-title":"Int Rev Psychiatry"},{"key":"2025082708082736000_17.1.e255333.2","doi-asserted-by":"crossref","first-page":"145","DOI":"10.36076\/ppj.2011\/14\/145","article-title":"A comprehensive review of opioid-induced hyperalgesia","volume":"14","author":"Lee","year":"2011","journal-title":"Pain Physician"},{"key":"2025082708082736000_17.1.e255333.3","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1097\/AJP.0000000000000994","article-title":"Opioid-induced hyperalgesia in patients with chronic pain: a systematic review of published cases","volume":"38","author":"Guichard","year":"2021","journal-title":"Clin J Pain"},{"key":"2025082708082736000_17.1.e255333.4","unstructured":"Opioid conversion calculator for morphine equivalents. 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