Managing acute-on-chronic pain in opioid-tolerant individuals is complex and challenging; exploring new analgesia regimens for this population is essential. Ketamine is an N-methyl D-aspartate antagonist that blocks transmission of painful stimuli and could be a useful medication for this patient population. A new low-dose ketamine protocol as an adjunct to conventional pain therapy was implemented in a major urban Level 1 trauma center in Canada. A retrospective before-and-after chart review was conducted to explore the research question, “What is the effect of low-dose ketamine continuous intravenous infusions on pain of highly opioid-tolerant adults following spinal surgery?”.

Patient-controlled analgesia (PCA) administered intravenously is a generally well-accepted therapy by nurses and patients. PCA devices are now available for oral medications, allowing patients to self-administer pain pills without requesting them from the nurse. Successful introduction of new pain medication delivery devices can depend on nurses’ knowledge and attitudes. The aim of this institutional review board approved project was to evaluate nurses’ perceptions and attitudes toward using an oral PCA device for patients’ pain.