Ketamine Mouthwash for Mucositis Pain

Purpose: Our objective was to determine if an oral ketamine swish and expectorate was a safe and effective method to alleviate mucositis pain. Methods: A retrospective chart audit was preformed on eight patients who received ketamine mouthwash (20 mg/5 mL) for refractory mucositis pain. Results: All eight patients had mucositis pain refractory to a mucositis mixture (lidocaine, magnesium/aluminum hydroxide, and diphenhydramine) and opioids. An improvement in mucositis pain was seen in over half (5/8) of the patients. Four of eight patients had adverse effects that could have been associated with the ketamine mouthwash; all side effects were transient and subsided when the ketamine mouthwash was stopped. Conclusion: Ketamine swish and expectorate may be a viable treatment option in refractory mucositis pain.