burning pain, allodynia and hyperalgesia, even after stopping the irritant factor. Opioid-induced
hyperalgesia and peripheral nerve injuries in lower extremities orthopedic surgeries can also
make the same symptoms, which sometimes make it difficult to diagnose it from causalgia (type
II complex regional pain syndrome). Post-traumatic neuralgia is not so common, often does not
respond well to usual medications and prolongs the patient’s stay in hospital. Noting the
anatomical and physiological aspects of pain transmission pathways and also role of pain
transmission inhibitors via NMDA receptors in pain management, opens us a new window to the
role of medicines such as ketamine in prevention and treatment of neuropathic or chronic postoperative
pains. We report a case involving refractory neuropathic pain which is eventually
controlled with low dose of ketamine.
