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https://www.readbyqxmd.com/read/28731926/history-of-anaesthesia-the-ketamine-story-past-present-and-future
#1
Georges Mion
: Ketamine's history begins in the 1950s in Detroit, Michigan, at Parke-Davis Laboratories. On 26 March 1956, Harold V. Maddox synthesised phencyclidine or PCP. Domino studied PCP effects in animals and in 1958, Greifenstein made the first trials of PCP in humans under the name of Sernyl. Sernyl did not cause depression of cardiovascular and respiratory functions, but elicited severe excitation with a very prolonged postoperative recovery. Because of its psychedelic effects, it became a street drug under the name of 'angel dust' and was placed on schedule II of Federal Controlled Substance Act (CSA) in 1978...
July 20, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28728322/perioperative-hypertension-management-during-facelift-under-local-anesthesia-with-intravenous-hypnotics
#2
Ki Ho Chung, Myeong Soo Cho, Hoon Jin
Perioperative hypertension is a phenomenon in which a surgical patient's blood pressure temporarily increases throughout the preoperative and postoperative periods and remains high until the patient's condition stabilizes. This phenomenon requires immediate treatment not only because it is observed in a majority of patients who are not diagnosed with high blood pressure, but also because occurs in patients with underlying essential hypertension who show a sharp increase in their blood pressure. The most common complication following facelift surgery is hematoma, and the most critical risk factor that causes hematoma is elevated systolic blood pressure...
July 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/28707454/interventions-for-postoperative-pain-in-children-an-overview-of-systematic-reviews
#3
REVIEW
Krste Boric, Svjetlana Dosenovic, Antonia Jelicic Kadic, Marijan Batinic, Marija Cavar, Marjan Urlic, Nikolina Markovina, Livia Puljak
The aim of this study was to conduct an overview of systematic reviews that summarizes the results about efficacy and safety from randomized controlled trials involving the various strategies used for postoperative pain management in children. We searched the Cochrane Database of Systematic Reviews, CINAHL, Database of Reviews of Effect, Embase, MEDLINE, and PsycINFO from the earliest date to January 24, 2016. This overview included 45 systematic reviews that evaluated interventions for postoperative pain in children...
July 14, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28700455/perioperative-ketamine-for-analgesia-in-spine-surgery-a-meta-analysis-of-randomized-controlled-trials
#4
Arif Pendi, Ryan Field, Saifal-Deen Farhan, Martin Eichler, Stacey Samuel Bederman
STUDY DESIGN: Meta-analysis of randomized controlled trials. OBJECTIVE: To evaluate the effectiveness of perioperative supplemental ketamine to reduce postoperative opioid analgesic consumption following spine surgery. SUMMARY OF BACKGROUND DATA: Although low-dose supplemental ketamine has been known to reduce pain after surgery, there is conflicting evidence regarding whether ketamine can be effective to reduce opioid consumption following spine surgery...
July 11, 2017: Spine
https://www.readbyqxmd.com/read/28682950/baseline-morphine-consumption-may-explain-between-study-heterogeneity-in-meta-analyses-of-adjuvant-analgesics-and-improve-precision-and-accuracy-of-effect-estimates
#5
Brett Doleman, Alex J Sutton, Matthew Sherwin, Jonathan N Lund, John P Williams
BACKGROUND: Statistical heterogeneity can increase the uncertainty of results and reduce the quality of evidence derived from systematic reviews. At present, it is uncertain what the major factors are that account for heterogeneity in meta-analyses of analgesic adjuncts. Therefore, the aim of this review was to identify whether various covariates could explain statistical heterogeneity and use this to improve accuracy when reporting the efficacy of analgesics. METHODS: We searched for reviews using MEDLINE, EMBASE, CINAHL, AMED, and the Cochrane Database of Systematic Reviews...
July 4, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28682644/assessing-analgesia-equivalence-and-appetite-following-alfaxalone-or-ketamine-based-injectable-anesthesia-for-feline-castration-as-an-example-of-enhanced-recovery-after-surgery
#6
Tatum Armstrong, Marika C Wagner, Jagjit Cheema, Daniel Sj Pang
Objectives The primary study objective was to assess two injectable anesthetic protocols, given to facilitate castration surgery in cats, for equivalence in terms of postoperative analgesia. A secondary objective was to evaluate postoperative eating behavior. Methods Male cats presented to a local clinic were randomly assigned to receive either intramuscular ketamine (5 mg/kg, n = 26; KetHD) or alfaxalone (2 mg/kg, n = 24; AlfHD) in combination with dexmedetomidine (25 μg/kg) and hydromorphone (0.05 mg/kg)...
February 1, 2017: Journal of Feline Medicine and Surgery
https://www.readbyqxmd.com/read/28663631/influence-of-difference-in-timing-of-perioperative-administration-of-low-dose-ketamine-on-postoperative-analgesia
#7
Ragi Jain, Namrata Kochhar
BACKGROUND: Preemptive analgesia is a part of multimodal regime for effective postoperative analgesia. Ketamine is said to possess preemptive effects, which has been simultaneously refuted by other studies. Hence, we designed this randomized, double-blinded trial to establish the influence of timing of perioperative ketamine administration for superior postoperative analgesia. METHODS: Ninety patients undergoing infraumbilical surgeries under spinal anesthesia were randomized to receive ketamine either preincision (Group KI), preincision and during skin closure (Group KII), or only during skin closure (Group KIII)...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28663627/efficacy-of-low-dose-ketamine-as-sole-analgesic-agent-in-maintaining-analgesia-and-intraoperative-hemodynamics-during-laparoscopic-gynecological-surgeries
#8
Dipti Saxena, Atul Dixit, Naina Kumar, Bipin Arya, Sadhana Sanwatsarkar, Shilpa Bhandari
BACKGROUND: Ketamine, in low doses, is known to possess intense analgesic properties. The available literature shows wide variation regarding the time and dose of administration of ketamine during surgery. AIM: The aim of this study was to evaluate the effect of intraoperative administration of ketamine when used as sole analgesic in low doses, on hemodynamics and postoperative analgesia in patients undergoing laparoscopic gynecological surgery and compared on the basis of duration of surgery...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28656921/a-comparative-study-of-ketamine-gargle-and-lidocaine-jelly-application-for-the-prevention-of-postoperative-throat-pain-following-general-anaesthesia-with-endotracheal-intubation
#9
S O Aigbedia, K U Tobi, F E Amadasun
BACKGROUND: Postoperative throat pain is an established complication of general anaesthesia with endotracheal intubation. We thus sought to determine the incidence of postoperative throat pain and the efficacy of lidocaine jelly and ketamine gargle in the prevention of postoperative throat pain. MATERIALS AND METHOD: One hundred and fifty ASA I or II, male: female ratio of 1:2 patients, aged18 -64 year, scheduled for elective general surgery requiring general anaesthesia with endotracheal intubation were randomly recruited into two groups, ketamine (K group) and lidocaine (L group)...
June 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28638273/the-effect-of-nefopam-infusion-during-laparascopic-cholecystectomy-on-postoperative-pain
#10
Eun Mi Kim, Joo Hyun Jeon, Mi Hwa Chung, Eun Mi Choi, Seung Hwa Baek, Pil Hyun Jeon, Mi Hyeon Lee
Background: While recovery from remifentanil is fast due to its rapid metabolism, it can induce hyperalgesia by activation of N-methyl-D-aspartic acid (NMDA) receptors. Therefore, administration of NMDA receptor antagonists such as ketamine is effective in relieving hyperalgesia caused by remifentanil. A previous study showed that nefopam administration before anesthesia combined with low-dose remifentanil reduced pain and analgesic consumption during the immediate postoperative period. We hypothesized that intraoperative infusion of nefopam during laparoscopic cholecystectomy would be as effective as ketamine in controlling pain during the acute postoperative period after sevoflurane and remifentanil based anesthesia...
2017: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/28631150/low-dose-subcutaneous-ketamine-for-postoperative-pain-management-in-rwanda-a-dose-finding-study
#11
Jon Tuchscherer, William P McKay, Theogene Twagirumugabe
PURPOSE: Good pain control is not a normal part of surgical care in sub-Saharan Africa due to lack of resources. The primary objective of this study was to determine an efficacious dose of subcutaneous ketamine for postoperative pain for use in a future randomized controlled trial. METHODS: Following research ethics board and local hospital approval for this research, we obtained informed consent from 31 patients undergoing major surgery for a random walk dose-finding study...
June 19, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28625307/postcesarean-delivery-analgesia
#12
REVIEW
Brendan Carvalho, Alexander J Butwick
Effective pain management should be a key priority in women undergoing cesarean delivery. Suboptimal perioperative pain management is associated with chronic pain, greater opioid use, delayed functional recovery, impaired maternal-fetal bonding, and increased postpartum depression. Severe acute postoperative pain is also strongly associated with persistent pain after cesarean delivery. Multimodal analgesia is the core principle for cesarean delivery pain management. The use of neuraxial morphine and opioid-sparing adjuncts such as scheduled nonsteroidal anti-inflammatory medications and acetaminophen is recommended for all women undergoing cesarean delivery with neuraxial anesthesia unless contraindicated...
March 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/28576285/intraoperative-ketamine-for-prevention-of-postoperative-delirium-or-pain-after-major-surgery-in-older-adults-an-international-multicentre-double-blind-randomised-clinical-trial
#13
Michael S Avidan, Hannah R Maybrier, Arbi Ben Abdallah, Eric Jacobsohn, Phillip E Vlisides, Kane O Pryor, Robert A Veselis, Hillary P Grocott, Daniel A Emmert, Emma M Rogers, Robert J Downey, Heidi Yulico, Gyu-Jeong Noh, Yonghun H Lee, Christine M Waszynski, Virendra K Arya, Paul S Pagel, Judith A Hudetz, Maxwell R Muench, Bradley A Fritz, Witold Waberski, Sharon K Inouye, George A Mashour
BACKGROUND: Delirium is a common and serious postoperative complication. Subanaesthetic ketamine is often administered intraoperatively for postoperative analgesia, and some evidence suggests that ketamine prevents delirium. The primary purpose of this trial was to assess the effectiveness of ketamine for prevention of postoperative delirium in older adults. METHODS: The Prevention of Delirium and Complications Associated with Surgical Treatments [PODCAST] study is a multicentre, international randomised trial that enrolled adults older than 60 years undergoing major cardiac and non-cardiac surgery under general anaesthesia...
May 30, 2017: Lancet
https://www.readbyqxmd.com/read/28525529/is-intravenous-ketamine-effective-for-postoperative-pain-management-in-adults
#14
Camila Stuardo, Diego Lobos-Urbina, Fernando Altermatt
Ketamine is a N-Metil-D-Aspartate receptor antagonist that has been used as adjuvant in the acute postoperative pain management because of its analgesic properties. However, its role is not clearly determined. To answer this question, we searched in Epistemonikos database, which is maintained by screening multiple information sources. We identified 19 systematic reviews including 226 randomized trials overall. We extracted data and generated a summary of findings table using the GRADE approach. We concluded intravenous ketamine probably has little or no effect in reducing postoperative pain...
May 17, 2017: Medwave
https://www.readbyqxmd.com/read/28520955/effect-of-intrathecally-administered-ketamine-morphine-and-their-combination-added-to-bupivacaine-in-patients-undergoing-major-abdominal-cancer-surgery-a-randomized-double-blind-study
#15
Ahmad M Abd El-Rahman, Ashraf A Mohamed, Sahar A Mohamed, Mohamed A M Mostafa
Objective. : Effective postoperative pain control reduces postoperative morbidity. In this study, we investigated the effects of intrathecal morphine, ketamine, and their combination with bupivacaine for postoperative analgesia in major abdominal cancer surgery. Study Design. : Prospective, randomized, double-blind. Setting. : Academic medical center. Patients and Methods.:  Ninety ASA I-III patients age 30 to 50 years were divided randomly into three groups: the morphine group (group M) received 10 mg of hyperbaric bupivacaine 0...
May 17, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28442956/a-comparison-between-intravenous-lidocaine-and-ketamine-on-acute-and-chronic-pain-after-open-nephrectomy-a-prospective-double-blind-randomized-placebo-controlled-study
#16
Ali Jendoubi, Imed Ben Naceur, Abderrazak Bouzouita, Mehdi Trifa, Salma Ghedira, Mohamed Chebil, Mohamed Houissa
BACKGROUND: Recently, there has been increasing interest in the use of analgesic adjuncts such as intravenous (IV) ketamine and lidocaine. OBJECTIVES: To compare the effects of perioperative IV lidocaine and ketamine on morphine requirements, pain scores, quality of recovery, and chronic pain after open nephrectomy. STUDY DESIGN: A prospective, randomized, placebo-controlled, double-blind trial. SETTINGS: The study was conducted in Charles Nicolle University Hospital of Tunis...
April 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28409242/comparison-of-topical-ropivacaine-with-and-without-ketamine-on-post-surgical-pain-in-children-undergoing-tonsillectomy-a-randomized-controlled-double-blind-study
#17
Boohwi Hong, Chae Seong Lim, Yoon-Hee Kim, Jung Un Lee, Yong Min Kim, Choonho Jung, Yumin Jo
PURPOSE: Tonsillectomy in pediatric patients may cause severe postoperative pain. Topical local anesthetics are an easy and safe way to control post-tonsillectomy pain, but there is no benefit during the early postoperative stage. Topical ketamine shows a good effect on early stage postoperative pain. We compared the effect of topical ropivacaine with and without ketamine on post-tonsillectomy pain. METHODS: Patients aged 3-7 years undergoing tonsillectomy were selected to participate in the study...
August 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28403113/incidence-of-persistent-postoperative-pain-after-hepatectomies-with-2-regimes-of-perioperative-analgesia-containing-ketamine
#18
COMPARATIVE STUDY
Paula Masgoret, Carmen Gomar, Beatriz Tena, Pilar Taurá, José Ríos, Miquel Coca
Studies designed to assess persistent postoperative pain (PPP) incidence after hepatectomies are lacking. Our aim was to assess PPP incidence 6 months after hepatectomies with intravenous (IV) or epidural (EPI) analgesia containing ketamine.Prospective observational comparative study between 2 cohorts of patients submitted to hepatectomy. Patients received 1 of 2 analgesic regimes containing ketamine: EPI group or IV group. Visual analog scale (VAS), Neuropathic Pain Symptom Inventory (NPSI), Pain Catastrophizing Scale (PCS), and quantitative sensorial testing (QST: to determine area of hyperalgesia/allodynia) were assessed preoperatively and postoperatively at 2 h, 24 h, 7 days, 1 month, and 6 months...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28365208/postoperative-hyperalgesia-a-clinically-applicable-narrative-review
#19
REVIEW
Avi A Weinbroum
Postoperative hyperalgesia (POH) is a condition characterized by signs and symptoms of pain despite the provision of conventional analgesia. In most cases, anesthesiologists are called upon soon after surgery, but occasionally it may occur as a late event. Persistent uncontrolled pain may transform into chronic or neuropathic pain. Correct diagnosis of POH is essential since similar phenomenon may exacerbate if misdiagnosed, while proper treatment is frequently achievable by pharmacological remedies. This review will describe the causes for POH and its bio-neuro-pharmacological basis, and clinical symptoms and signs directing the physician towards correct diagnosis of this paradoxical condition of pain, as well as modes capable of preventing POH from occurring...
June 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/28357557/single-bolus-low-dose-of-ketamine-does-not-prevent-postpartum-depression-a-randomized-double-blind-placebo-controlled-prospective-clinical-trial
#20
Yang Xu, Yuantao Li, Xiaolei Huang, Daili Chen, Baozuan She, Daqing Ma
PURPOSE: Postpartum depression is a common complication of childbirth. In the last decade, it has been suggested that subdissociative-dose ketamine is a fast-acting antidepressant. We aimed to investigate the efficacy of low-dose ketamine administered during caesarean section in preventing postpartum depression. METHODS: Using a randomized, double-blind, placebo-controlled design, 330 parturients who were scheduled to undergo caesarean section were enrolled in this trial...
May 2017: Archives of Gynecology and Obstetrics
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