Beneficial effect of low-dose ketamine addition to epidural administration of morphine-bupivacaine mixture for cancer pain in two cases.

Two patients experiencing cancer pain with neuropathic components were treated with epidural administration of a mixture of ketamine (1 mg/mL) + morphine (1 mg/mL) + bupivacaine (1 mg/mL) injected daily by epidural port. No serious adverse effect was observed throughout the therapy. The patients were mostly pain-free and have gotten better quality of life during 110- and 48-day follow-up when the therapy was given by epidural route. Low doses of epidural ketamine added to morphine and bupivacaine increase the mean duration of satisfactory analgesia without severe adverse effects and restore quality of life when traditional therapy fails.