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Ketamine chronic pain

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https://www.readbyqxmd.com/read/29775120/successful-improvement-of-pain-symptomatology-in-a-suspected-case-of-cramp-fasciculation-syndrome-via-interventional-pain-treatment
#1
Anita Gupta, Lucas First, Celeste A Swain
Peripheral nerve hyperexcitability (PNH) syndromes are a rare set of neuromuscular disorders that include cramp-fasciculation syndrome (CFS) and Isaacs syndrome (IS). Successful treatment of these diseases has been achieved with antiepileptic medications; however, chronic pain symptoms can persist. We provide a case report of a 25-year-old female who has suffered from painful severe muscle spasms and fasciculations since childhood. With CFS as our working diagnosis, a treatment regimen using interventional pain techniques, including sympathetic chain blocks, ketamine infusions, and trigger point injections, resulted in a significant decrease in the patient's chronic pain symptoms...
May 18, 2018: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/29773953/mir-34a-mediated-regulation-of-xist-in-female-cells-under-inflammation
#2
Botros B Shenoda, Yuzhen Tian, Guillermo M Alexander, Enrique Aradillas-Lopez, Robert J Schwartzman, Seena K Ajit
Background: Evidence is overwhelming for sex differences in pain, with women representing the majority of the chronic pain patient population. There is a need to explore novel avenues to elucidate this sex bias in the development of chronic inflammatory pain conditions. Complex regional pain syndrome (CRPS) is a chronic neuropathic pain disorder, and the incidence of CRPS is greater in women than in men by ~4:1. Since neurogenic inflammation is a key feature of CRPS, dysregulation of inflammatory responses can be a factor in predisposing women to chronic pain...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29760856/continuous-intravenous-sub-dissociative-dose-ketamine-infusion-for-managing-pain-in-the-emergency-department
#3
Sergey Motov, Jefferson Drapkin, Antonios Likourezos, Tyler Beals, Ralph Monfort, Christian Fromm, John Marshall
Introduction: Our objective was to describe dosing, duration, and pre- and post-infusion analgesic administration of continuous intravenous sub-dissociative dose ketamine (SDK) infusion for managing a variety of painful conditions in the emergency department (ED). Methods: We conducted a retrospective chart review of patients aged 18 and older presenting to the ED with acute and chronic painful conditions who received continuous SDK infusion in the ED for a period over six years (2010-2016)...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29753795/non-anesthetic-effects-of-ketamine-a-review-article-authors-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2
#4
REVIEW
Jabril Eldufani, Alireza Nekoui, Gilbert Blaise
Ketamine is considered a dissociative anesthetic medication, and it is a commonly administered by a parenteral route. It works mainly by blocking the N-methyl-D-aspartate (NMDA) receptor. It inhibits the voltage-gated Na_ and K_ channels and serotonin and dopamine re-uptake; also, it affects specific receptors, such as α-amino-3-hydroxy-5-methyl-4- isoxazolepropionic acid (AMPA), kainate and aminobutyric acid A receptors. Ketamine appears to have particular mechanisms that are potentially involved during analgesic induction, including enhancing of descending inhibition and anti-inflammatory effects...
May 10, 2018: American Journal of Medicine
https://www.readbyqxmd.com/read/29742620/ketamine-differentially-restores-diverse-alterations-of-neuroligins-in-brain-regions-in-a-rat-model-of-neuropathic-pain-induced-depression
#5
Wei Pan, Guang-Fen Zhang, Hui-Hui Li, Mu-Huo Ji, Zhi-Qiang Zhou, Kuan-Yu Li, Jian-Jun Yang
Depression is present in a large proportion of patients suffering from chronic pain, and yet the underlying mechanisms remain to be elucidated. Neuroligins (NLs), as a family of cell-adhesion proteins, are involved in synaptic formation and have been linked to various neuropsychiatric disorders. Here, we studied the alterations in NL1 and NL2 in the medial prefrontal cortex (mPFC), the anterior cingulate cortex (ACC), and the hippocampus in a rat model of neuropathic pain-induced depression, and whether ketamine, a rapid and robust antidepressant, could restore these abnormalities...
May 8, 2018: Neuroreport
https://www.readbyqxmd.com/read/29739543/special-indications-for-opioid-free-anaesthesia-and-analgesia-patient-and-procedure-related-including-obesity-sleep-apnoea-chronic-obstructive-pulmonary-disease-complex-regional-pain-syndromes-opioid-addiction-and-cancer-surgery
#6
REVIEW
Adrian Sultana, David Torres, Roman Schumann
Opioid-free anaesthesia (OFA) is a technique where no intraoperative systemic, neuraxial or intracavitary opioid is administered with the anaesthetic. Opioid-free analgesia similarly avoids opioids in the perioperative period. There are many compelling reasons to avoid opioids in the surgical population. A number of case reports and, increasingly, prospective studies from all over the world support its benefits, especially in the morbidly obese population with or without sleep apnoea. A derivative technique is opioid sparing, where the same techniques are used but some opioid use is allowed...
December 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29730359/emerging-trends-in-pain-medication-management-back-to-the-future-a-focus-on-ketamine
#7
REVIEW
Meredith W Crumb, Candace Bryant, Timothy J Atkinson
Providers face many challenges when faced with pain management. Pain is complex, difficult to understand, diagnose, and especially enigmatic to manage. The discovery of non-opioid agents for pain management has become particularly important considering the on-going opioid epidemic. This review is focused on revisiting Ketamine, an agent that has historically been used for anesthesia in new ways to manage pain. Ketamine has unique pharmacologic properties that may prevent the development of pain as well as reduce chronic pain...
May 3, 2018: American Journal of Medicine
https://www.readbyqxmd.com/read/29713269/effects-of-subanesthetic-ketamine-administration-on-visual-and-auditory-event-related-potentials-erp-in-humans-a-systematic-review
#8
André Schwertner, Maxciel Zortea, Felipe V Torres, Wolnei Caumo
Ketamine is a non-competitive N-Methyl-D-Aspartate (NMDA) receptor antagonist whose effect in subanesthetic doses has been studied for chronic pain and mood disorders treatment. It has been proposed that ketamine could change the perception of nociceptive stimuli by modulating the cortical connectivity and altering the top-down mechanisms that control conscious pain perception. As this is a strictly central effect, it would be relevant to provide fresh insight into ketamine's effect on cortical response to external stimuli...
2018: Frontiers in Behavioral Neuroscience
https://www.readbyqxmd.com/read/29570151/incidence-and-risk-factors-for-chronic-postoperative-opioid-use-after-major-spine-surgery-a-cross-sectional-study-with-longitudinal-outcome
#9
Lauren K Dunn, Sandeep Yerra, Shenghao Fang, Mark F Hanak, Maren K Leibowitz, Siny Tsang, Marcel E Durieux, Edward C Nemergut, Bhiken I Naik
BACKGROUND: Chronic opioid use is a significant public health concern. Surgery is a risk factor for developing chronic opioid use. Patients undergoing major spine surgery frequently are prescribed opioids preoperatively and may be at risk for chronic opioid use postoperatively. The aim of this study was to investigate the incidence of and perioperative risk factors associated with chronic opioid use after major spine surgery. METHODS: The records of patients who underwent elective major spine surgery at the University of Virginia between March 2011 and February 2016 were retrospectively reviewed...
March 21, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29568261/8-o-acetyl-shanzhiside-methylester-from-lamiophlomis-rotata-reduces-neuropathic-pain-by-inhibiting-the-erk-tnf-%C3%AE-pathway-in-spinal-astrocytes
#10
Wei Zhang, Yang Bai, Yu Qiao, Jian Wang, Meng-Ying Li, Jing-Wen Wang, Na Jia, Tao Chen, Yun-Qing Li, Ai-Dong Wen
Lamiophlomis rotata ( L. rotata ; Benth.) Kudo is an effective traditional herb in the clinical treatment of chronic pain syndromes in China. 8-O-acetyl shanzhiside methylester (8-OaS), a chief component in L. rotata , possesses potent immunosuppressive activities and favorable analgesic effects. This study was proposed to compare the analgesic effects of 8-OaS with those of lidocaine and ketamine in a spinal nerve ligation (SNL) model by behavioral tests, and then investigated its effects upon the expression of spinal glial fibrillary acidic protein (GFAP), phosphorylated extracellular regulated protein kinases (pERK) and tumor necrosis factor-alpha (TNF-α) via immunofluorescence staining and western blot analyses...
2018: Frontiers in Cellular Neuroscience
https://www.readbyqxmd.com/read/29553987/chronic-postsurgical-pain-and-cancer-the-catch-of-surviving-the-unsurvivable
#11
Stephen R Humble, Nicolas Varela, Asantha Jayaweera, Arun Bhaskar
PURPOSE OF REVIEW: Chronic postsurgical pain (CPSP) is an important and well recognized cause of much long-term suffering, which in some cases may be preventable and affects many people living with cancer. Unfortunately, general consensus is lacking as to how best reduce the risk of developing CPSP. RECENT FINDINGS: Cancer is now not always a short-lived, fatal disease and is now moving towards a chronic illness. Poorly managed perioperative pain is the greatest risk factor for CPSP...
March 16, 2018: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/29517981/pain-management-in-neurocritical-care-an-update
#12
Athir Morad, Salia Farrokh, Alexander Papangelou
PURPOSE OF REVIEW: Pain management in neurocritical care is a subject often avoided because of concerns over the side-effects of analgesics and the potential to cause additional neurological injury with treatment. The sedation and hypercapnia caused by opioids have been feared to mask the neurological examination and contribute to elevations in intracranial pressure. Nevertheless, increasing attention to patient satisfaction has sparked a resurgence in pain management. As opioids have remained at the core of analgesic therapy, the increasing attention to pain has contributed to a growing epidemic of opioid dependence...
April 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29510816/adjuvant-analgesics-for-spine-surgery
#13
Rikke Vibeke Nielsen
Increasing evidence indicate that pain is insufficiently treated following surgical procedures. It is essential that pain treatment is effective with a minimum of side effects in order to promote postoperative rehabilitation. Multimodal analgesia is most likely an important strategy in reducing postoperative pain. Combinations of different analgesics with different mechanisms of action may have an additive analgesic effect with fewer side effects compared to using a single drug. However, there is still a pronounced lack of documentation for the effect and side effects of these multimodal analgesic regimes...
March 2018: Danish Medical Journal
https://www.readbyqxmd.com/read/29474216/anesthesia-and-analgesia-for-gynecological-surgery
#14
Allana Munro, Ana Sjaus, Ronald B George
PURPOSE OF REVIEW: High-quality analgesia has been linked to improved patient satisfaction as well as improved short-term and long-term postoperative outcomes. Acute surgical pain is a modifiable risk factor for development of chronic postoperative pain, which is reported by up to 26% of gynecologic surgical patients. In other surgical populations, multimodal analgesia has shown improved pain control and decreased reliance on opioids. This review examines recent evidence for various analgesic modalities applied specifically to the gynecologic surgical population...
June 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29404791/chronification-of-pain-mechanisms-current-understanding-and-clinical-implications
#15
REVIEW
Daniel J Pak, R Jason Yong, Alan David Kaye, Richard D Urman
PURPOSE OF REVIEW: The development of acute to chronic pain involves distinct pathophysiological changes in the peripheral and central nervous systems. This article reviews the mechanisms, etiologies, and management of chronic pain syndromes with updates from recent findings in the literature. RECENT FINDINGS: Chronic post-surgical pain (CPSP) is not limited to major surgeries and can develop after smaller procedures such as hernia repairs. While nerve injury has traditionally been thought to be the culprit for CPSP, it is evident that nerve-sparing surgical techniques are not completely preventative...
February 5, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29404715/the-effect-of-ketamine-infusion-in-the-treatment-of-complex-regional-pain-syndrome-a-systemic-review-and-meta-analysis
#16
REVIEW
Jianli Zhao, Yajing Wang, Dajie Wang
PURPOSE OF REVIEW: Complex regional pain syndrome (CRPS) is a painful debilitating neurological condition that accounts for approximately 1.2% of adult chronic pain population. Ketamine, an NMDA receptor antagonist, is an anesthetic agent that has been used by some pain specialists for CRPS. There is a growing body of clinical evidence to support the use of ketamine in the treatment of neuropathic pain, especially CRPS. This meta-analysis study was aimed to examine the efficacy of ketamine in the treatment of CRPS...
February 5, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29396996/intranasal-ketamine-and-its-potential-role-in-cancer-related-pain
#17
REVIEW
Vinita Singh, Theresa W Gillespie, Robert Donald Harvey
Cancer-related pain continues to be a significant therapeutic challenge, made more difficult by contemporary opioid use and diversion concerns. Conventional treatment using a tiered approach of nonsteroidal antiinflammatory drugs (NSAIDs), opioids, and adjuvant agents is limited; and alternatives are needed for patients with rapidly progressing pain and those who develop hyperalgesia and tolerance to opioids. Ketamine, an N-methyl-d-aspartate (NMDA) selective antagonist, has historically been used for anesthesia in adult and pediatric populations but has also been investigated for depression, bipolar disorder, and general and postoperative pain management...
March 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29392238/complex-regional-pain-syndrome-up-to-date
#18
Frank Birklein, Violeta Dimova
Complex regional pain syndrome (CRPS) was described for the first time in the 19th century by Silas Weir Mitchell. After the exclusion of other causes, CRPS is characterised by a typical clinical constellation of pain, sensory, autonomic, motor, or trophic symptoms which can no longer be explained by the initial trauma. These symptoms spread distally and are not limited to innervation territories. If CRPS is not improved in the acute phase and becomes chronic, the visible symptoms change throughout because of the changing pathophysiology; the pain, however, remains...
November 2017: Pain Reports (Baltimore, Md.)
https://www.readbyqxmd.com/read/29178663/ketamine-for-chronic-non-cancer-pain-a-meta-analysis-and-trial-sequential-analysis-of-randomized-controlled-trials
#19
REVIEW
D Michelet, C Brasher, A-L Horlin, M Bellon, F Julien-Marsollier, T Vacher, S Pontone, S Dahmani
BACKGROUND: Ketamine has been suggested to be efficient in relieving chronic pain. However, there is inconsistency across studies investigating the effect of ketamine for chronic pain management. We aimed to perform a meta-analysis in order to assess the efficacy of this compound during chronic non-cancer pain conditions. METHODS: The study consisted in a meta-analysis of clinical trials comparing ketamine to a placebo during chronic non-cancer pain. The primary endpoint of this study was pain relief 4 weeks after the beginning of treatment...
April 2018: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/29135531/recurrent-subanesthetic-ketamine-infusions-for-complex-regional-pain-syndrome-leading-to-biliary-dilation-jaundice-and-cholangitis-a-case-report
#20
Nathan A Hewitt, Peter Cox
Complex regional pain syndrome is a chronic pain condition that may be resistant to many treatment modalities. Ketamine infusions have demonstrated some promising results, though their use may be associated with a number of adverse effects limiting their widespread applicability. Hepatotoxicity and cholangiopathy have been described in chronic ketamine abuse, though rarely in therapeutic use. We report the impact of recurrent short subanesthetic ketamine infusions for the treatment of complex regional pain syndrome resulting in biliary dilation, jaundice, and cholangitis...
November 9, 2017: A & A Case Reports
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