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Keith Weisz, Lalit Bajaj, Sara J Deakyne, Lina Brou, Alison Brent, Joseph Wathen, Genie E Roosevelt
BACKGROUND: The co-administration of ketamine and propofol (CoKP) is thought to maximize the beneficial profile of each medication, while minimizing the respective adverse effects of each medication. OBJECTIVE: Our objective was to compare adverse events between ketamine monotherapy (KM) and CoKP for procedural sedation and analgesia (PSA) in a pediatric emergency department (ED). METHODS: This was a prospective, randomized, single-blinded, controlled trial of KM vs...
April 19, 2017: Journal of Emergency Medicine
Mona Mohamed Mogahd, Mohammed Shafik Mahran, Ghada Foad Elbaradi
BACKGROUND AND AIMS: Prolonged mechanical ventilation after cardiac surgery is associated with serious complications that increase morbidity and mortality. The present study was designed to compare ketamine-propofol (KP) and ketamine-dexmedetomidine (KD) combinations for sedation and analgesia in patients after coronary artery bypass graft (CABG) surgery as regards hemodynamics, total fentanyl dose, time of weaning from mechanical ventilation, time of extubation, and any adverse outcome...
April 2017: Annals of Cardiac Anaesthesia
Andrew D Franklin, Jenna H Sobey, Eric T Stickles
Electroconvulsive therapy is being used more frequently in the treatment of many chronic and acute psychiatric illnesses in children. The most common psychiatric indications for pediatric electroconvulsive therapy are refractory depression, bipolar disorder, schizophrenia, catatonia, and autism. In addition, a relatively new indication is the treatment of pediatric refractory status epilepticus. The anesthesiologist may be called upon to assist in the care of this challenging and vulnerable patient population...
May 2017: Paediatric Anaesthesia
Yasemin Burcu Ustun, Yunus Oktay Atalay, Ersin Koksal, Cengiz Kaya, Fatih Ozkan, Elif Bengi Sener, Ahmet Veysel Polat
OBJECTIVE: To compare the efficiency of intravenous thiopental against intravenous ketamine-propofol combination in paediatric sedation for magnetic resonance imaging. METHODS: This prospective study was conducted at Ondokuz Mayis University Hospital, Samsun, Turkey, from July 1, 2014, to January 1, 2015, and comprised children aged 1 month to 12 years undergoing elective magnetic resonance imaging who were randomly assigned to two equal groups. Group I received thiopental 3 mg/kg intravenously followed by an additional dose of thiopental 1 mg/kg to achieve a Ramsay sedation score of 4...
February 2017: JPMA. the Journal of the Pakistan Medical Association
Xin Wang, Qi Deng, Bin Liu, Xiangdi Yu
Using sevoflurane for pediatric anesthesia plays a pivotal role in surgeries. Emergence agitation (EA) is a major adverse event accompanied with pediatric anesthesia. Other anesthetic adjuvants can be combined with sevoflurane in clinical practices for different purposes. However, it is uncertain that such a practice may have substantial influence on the risk of EA. We conducted a literature search in online databases, including PubMed, Embase, Cochrane Library, and Clinical Trials. Key data were extracted from eligible randomized control trials (RCTs)...
November 4, 2016: Molecular Neurobiology
Dilek Gunay Canpolat, Mustafa Denizhan Yildirim, Recep Aksu, Nukhet Kutuk, Alper Alkan, Kenan Cantekin
BACKGROUND AND OBJECTIVE: Dental treatments cannot bealways performed under local anesthesia inpediatric non-cooperative patients. For this purpose, differentanesthetic techniques have been applied to increase patient comport to dental treatments. METHODS: Sixty children classified as ASA I-II, between aged 3 to 9, who were scheduled to undergo tooth extraction, were enrolled for this randomized study. Group K received 1 mg/kg ketamine, Group P received 1 mg/kg propofol, and Group KP received 0...
May 2016: Pakistan Journal of Medical Sciences Quarterly
Özgür Yağan, Refika Hande Karakahya, Nilay Taş, Ahmet Küçük
OBJECTIVE: The aim of this study is to compare the sedative properties and haemodynamic and respiratory effects of dexmedetomidine and a ketamine-propofol combination (ketofol), which are expected to have minimal effects on spontaneous breathing. METHODS: Sixty patients were enrolled in this prospective randomised study. Patients were divided into 2 groups according to the administration of dexmedetomidine (Group D) and ketofol (Group K). Target sedation level was determined as a Ramsay Sedation Score of 3...
April 2015: Turkish Journal of Anaesthesiology and Reanimation
Mustafa Said Aydoğan, Soner Demirel, Mehmet Ali Erdoğan, Penpegül Fırat, Cemil Çolak, Mahmut Durmuş
OBJECTIVE: The aim of this study was to compare the effects of a ketamine-propofol mixture (ketofol) and propofol on intraocular pressure (IOP) and haemodynamics in elderly patients during anaesthetic management at each repeated measurement times. METHODS: Forty elderly ASA I and II patients were divided into two random groups and received either propofol (1.5 mg kg(-1); group P, n=20) or ketofol (1:1 single syringe mixture of 5 mg mL(-1) ketamine and 5 mg mL(-1) propofol; group KP, n=20)...
February 2014: Turkish Journal of Anaesthesiology and Reanimation
Vida Ayatollahi, Maryam Vafaiyan, Maryam Hatami, Shekoufeh Behdad
OBJECTIVES: Ketofol is a mixture of propofol and ketamine in various concentrations. It is accepted as a suitable combination in procedural sedation and analgesia. The mixture of propofol and ketamine with different respiratory and hemodynamic effects may result in fewer dose-related side effects and a probable synergistic effect. This study was designed to compare the adverse effects and quality of analgesia of 2 different intravenous concentrations of ketofol in patients undergoing closed reduction of the nose...
June 2016: Journal of Craniofacial Surgery
Xiaomei Zhong, Hongbo He, Chunping Zhang, Zhijie Wang, Miaoling Jiang, Qirong Li, Minling Zhang, Xiong Huang
BACKGROUND: Treatment-resistant depression (TRD) is a growing clinical challenge. Electroconvulsive therapy (ECT) is an effective tool for TRD treatment. However, there remains a subset of patients who do not respond to this treatment with common anesthetic agent. Ketamine, a noteworthy anesthetic agent, has emerged as an augmentation to enhance the antidepressant efficacy of ECT. Trials of i.v. ketamine in TRD indicated dose-related mood enhancing efficacy. We aimed to explore anesthetic and subanesthetic concentrations of ketamine in ECT for TRD with respect to their impact on mood and neuropsychological effects...
September 1, 2016: Journal of Affective Disorders
Li-Hong Jin, Yan-Yan Song, Yang Shen, Wei Ji, Ma-Zhong Zhang
BACKGROUND: This aim of this study was to determine the effects of ketamine-propofol combination on learning and memory, as well as exercise, on anesthetic neurotoxicity. MATERIAL/METHODS: A ketamine-propofol combination was administered once (group SKP, Single Ketamine Propofol) on P7 (postnatal day 7) or in 3 treatments on P6, P8, and P10 (group MKP, Multiple Ketamine Propofol). Rat pups in group C (Control) received equivalent volumes of normal saline in 3 injections on P6, P8, and P10...
March 30, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Sema Oncul, Elif Atar Gaygusuz, Mehmet Yilmaz, Hasan Terzi, Canan Balci
BACKGROUND: This study aimed to compare remifentanil and ketamine-propofol in terms of hemodynamic response, duration of recovery and patient satisfaction in operative hysteroscopy cases who underwent monitored anaesthesia care in combination with paracervical block. METHODS: Monitored anaesthesia care was used in 60 ASA I-II female patients. The patients were divided into two groups as remifentanil (Group R) and ketamine-propofol (Group K-P). The hemodynamic effects of remifentanil and ketamine-propofol, and duration of recovery were recorded and compared...
2016: Anaesthesiology Intensive Therapy
Sheikh Sohail Ahmed, Shawn R Hicks, James E Slaven, Mara E Nitu
OBJECTIVE: Sedation may be needed for safe, effective completion of pediatric dental procedures. Procedural sedation is performed in a children's hospital based dental office. The three sedation approaches: a propofol-only (P-O) approach (2-3 mg/kg titrated to the needed level of sedation), an approach that includes either i.v. ketamine (K+P) (0.25 or 0.5 mg/kg) or i.v. fentanyl (F+P) (0.5-1 mcg/kg) prior to propofol administration. We sought to determine safety and efficacy of various propofol based sedation protocols...
2016: Journal of Clinical Pediatric Dentistry
Lihua Yang, Yucan Xu, Zhongyu Wang, Wei Zhang
The aim of this study was to evaluate the safety and efficacy of ultrasound-guided ilioinguinal/iliohypogastric nerve block (IINB) in pediatric patients undergoing same-day inguinal region surgery. Ninety patients aged 4-6 years, ASA levels I-II, were randomly divided into three groups: U, T, or C (n = 30 each). After basic anesthesia, patients in group U underwent ultrasound-guided IINB, those in group T underwent traditional Schulte-Steinberg IINB, and those in group C (controls) received intravenous anesthesia (ketamine-propofol) only...
December 2015: Indian Journal of Surgery
Martín Santos, Ana Viñuela, Angela A Vela, Francisco J Tendillo
OBJECTIVE: To evaluate and compare three intravenous (IV) doses of a ketamine-propofol admixture (ketofol) for induction of anaesthesia in unpremedicated rabbits. STUDY DESIGN: Prospective, randomized 'blinded' trial. ANIMALS: Twenty-one healthy female New Zealand rabbits weighing 2.7 ± 0.1 kg. METHODS: Animals were allocated randomly into three groups of seven animals and received 1 (KP1), 3 (KP3) or 5 (KP5) mg kg(-1) of both ketamine and propofol in a 1:1 mg kg(-1) ratio admixture...
September 2016: Veterinary Anaesthesia and Analgesia
Mohammad Jalili, Maryam Bahreini, Amin Doosti-Irani, Rasoul Masoomi, Mona Arbab, Hadi Mirfazaelian
OBJECTIVE: This meta-analysis of trials was conducted to evaluate the analgesic and side effects of ketamine-propofol combination (ketofol) in comparison to propofol in procedural sedation and analgesia (PSA). METHODS: Medline, EMBASE, Scopus, CINHAL, and Cochrane Central Register of Controlled Trials were searched for clinical trial. The administration complications were the key outcomes of interest. RESULT: Eighteen clinical trials that met our criteria were included in the analysis...
March 2016: American Journal of Emergency Medicine
M Fernanda Bellolio, Waqas I Gilani, Patricia Barrionuevo, M Hassan Murad, Patricia J Erwin, Joel R Anderson, James R Miner, Erik P Hess
OBJECTIVES: This was a systematic review and meta-analysis to evaluate the incidence of adverse events in adults undergoing procedural sedation in the emergency department (ED). METHODS: Eight electronic databases were searched, including MEDLINE, EMBASE, EBSCO, CINAHL, CENTRAL, Cochrane Database of Systematic Reviews, Web of Science, and Scopus, from January 2005 through 2015. Randomized controlled trials and observational studies of adults undergoing procedural sedation in the ED that reported a priori selected outcomes and adverse events were included...
February 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Francesca Campoccia Jalde, Fredrik Jalde, Peter V Sackey, Peter J Radell, Staffan Eksborg, Mats K E B Wallin
BACKGROUND: Spontaneous breathing during mechanical ventilation improves gas exchange by redistribution of ventilation to dependent lung regions. Neurally adjusted ventilatory assist (NAVA) supports spontaneous breathing in proportion to the electrical activity of the diaphragm (EAdi). NAVA has never been used in the operating room and no studies have systematically addressed the influence of different anaesthetic drugs on EAdi. OBJECTIVES: The aim of this study was to test the feasibility of NAVA under sedation and anaesthesia with two commonly used anaesthetics, sevoflurane and propofol, with and without remifentanil, and to study their effects on EAdi and breathing mechanics...
April 2016: European Journal of Anaesthesiology
Nathan J Smischney, Rahul Kashyap, Ognjen Gajic
Endotracheal intubation is frequently performed in the intensive care unit (ICU). It can be life-saving for many patients who present with acute respiratory distress. However, it is equally associated with complications that may lead to unwanted effects in this patient population. According to the literature, the rate of complications associated with endotracheal intubation is much higher in an environment such as the ICU as compared to other, more controlled environments (i.e., operating room). Thus, the conduct of performing such a procedure needs to be accomplished with the utmost care...
September 2015: Journal of Thoracic Disease
M Arikan, B Aslan, O Arikan, A But, E Horasanli
OBJECTIVE: The purpose of this study was to compare the propofol-remifentanil combination and propofol-ketamine combination for Dilatation and Curettage (DC) procedure. PATIENTS AND METHODS: This prospective, double blind, and randomized study comprised 81 female patients undergoing diagnostic DC. Patients were randomly allocated to one of two groups; propofol-remifentanil (Group PR, n= 44) or propofol-ketamine (Group PK, n= 37). The level of sedation was assessed with the Ramsay Sedation Score (RSS)...
September 2015: European Review for Medical and Pharmacological Sciences
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