A combination therapy of ketamine-amtriptyline for the intractable pain with restlessness of cancer patients in the end stage was presented. Seven patients with peritonitis carcinomatosis due to recurrence of stomach cancer were administrated the therapy. They ranged in age from 29 to 79 years. The results were eminently desirable. Intractable pain with restlessness were diminished by the therapy though languid feeling was yet remained. Anodyne (pentazocine), which was nessesary many times in one day before the therapy, was not used in the duration of
the therapy. The experimental and clinical studies of analgesic property of ketamine by HATANO revealed that it is more twice as potent an analgesic in low dosage compared with pethidine, despite its rather short duration of action. There was no respiratory depression. No hypotension nor bradycardia were observed during the therapy. The only use of ketamine however, could not release the pain and anguish of cancer patients. The author applied amitriptyline to these cases. The combination use of ketamine and amitriptyline could release them. These drugs demonstrated their full effect by the combination use.
