keyword
https://read.qxmd.com/read/33133700/the-effectiveness-of-ketamine-in-pediatric-acute-deafferentation-pain-after-spinal-cord-injury
#1
Devina G Shiwlochan, Misty Shah, Khushboo Baldev, Donna-Ann Thomas, Maxime Debrosse
Deafferentation pain and allodynia commonly occur after spinal cord trauma, but its treatment is often challenging. The literature on effective therapies for pediatric deafferentation pain, especially in the setting of spinal cord injury, is scarce. We report the case of a 12-year-old patient with acute allodynia after a gunshot injury to the spine. The pain was refractory to multiple analgesics, but resolved with ketamine, which also improved the patient's physical function and quality of life, a trend that continued many months after the injury...
2020: Case Reports in Anesthesiology
https://read.qxmd.com/read/33084081/low-dose-ketamine-affects-blood-pressure-but-not-muscle-sympathetic-nerve-activity-during-progressive-central-hypovolemia-without-altering-tolerance
#2
RANDOMIZED CONTROLLED TRIAL
Mu Huang, Joseph C Watso, Gilbert Moralez, Matthew N Cramer, Joseph M Hendrix, Jeung-Ki Yoo, Mark B Badrov, Qi Fu, Carmen Hinojosa-Laborde, Craig G Crandall
KEY POINTS: Haemorrhage is the leading cause of battlefield and civilian trauma deaths. Given that a haemorrhagic injury on the battlefield is almost always associated with pain, it is paramount that the administered pain medication does not disrupt the physiological mechanisms that are beneficial in defending against the haemorrhagic insult. Current guidelines from the US Army's Committee on Tactical Combat Casualty Care (CoTCCC) for the selection of pain medications administered to a haemorrhaging soldier are based upon limited scientific evidence, with the clear majority of supporting studies being conducted on anaesthetized animals...
December 2020: Journal of Physiology
https://read.qxmd.com/read/32939091/deep-posteromedial-cortical-rhythm-in-dissociation
#3
JOURNAL ARTICLE
Sam Vesuna, Isaac V Kauvar, Ethan Richman, Felicity Gore, Tomiko Oskotsky, Clara Sava-Segal, Liqun Luo, Robert C Malenka, Jaimie M Henderson, Paul Nuyujukian, Josef Parvizi, Karl Deisseroth
Advanced imaging methods now allow cell-type-specific recording of neural activity across the mammalian brain, potentially enabling the exploration of how brain-wide dynamical patterns give rise to complex behavioural states1-12 . Dissociation is an altered behavioural state in which the integrity of experience is disrupted, resulting in reproducible cognitive phenomena including the dissociation of stimulus detection from stimulus-related affective responses. Dissociation can occur as a result of trauma, epilepsy or dissociative drug use13,14 , but despite its substantial basic and clinical importance, the underlying neurophysiology of this state is unknown...
October 2020: Nature
https://read.qxmd.com/read/32821594/ketamine-administration-in-prehospital-combat-injured-patients-with-traumatic-brain-injury-a-10-year-report-of-survival
#4
JOURNAL ARTICLE
Allee C Torres, Vikhyat S Bebarta, Michael D April, Joseph K Maddry, Paco S Herson, Emma K Bebarta, Steven Schauer
Background The Tactical Combat Casualty Care (TCCC) guidelines recommend ketamine as the primary battlefield analgesic in the setting of moderate-to-severe pain and hemodynamic compromise. However, despite recent studies failing to support the association between ketamine and worse outcomes in head trauma, TCCC guidelines state that ketamine may worsen severe traumatic brain injury. We compared mortality outcomes following head trauma sustained in a combat setting between ketamine recipients and non-recipients...
July 17, 2020: Curēus
https://read.qxmd.com/read/32801635/the-effects-of-dexmedetomidine-and-ketamine-on-oxidative-injuries-and-histological-changes-following-blunt-chest-trauma
#5
JOURNAL ARTICLE
Seyfi Kartal, Gülay Kip, Ayşegül Küçük, Seyhan Sümeyra Aşçı, Özlem Erdem, Mustafa Arslan, Mustafa Kavutçu
Background: The objective of this research was to evaluate the oxidative and histopathological effects of dexmedetomidine and ketamine on the pulmonary contusion model resulting from blunt chest trauma. Methods: Rats were randomly assigned to 5 equal groups (n=6): control group (Group C), pulmonary contusion group (Group PC), PC-dexmedetomidine group (Group PC-D), PC-ketamine group (Group PC-K), and PC-dexmedetomidine + ketamine (Group PC-D+K). The PC was performed by dropping a weight of 500 g (2...
2020: Drug Design, Development and Therapy
https://read.qxmd.com/read/32782893/evaluation-of-safety-and-efficacy-of-prehospital-paramedic-administration-of-sub-dissociative-dose-of-ketamine-in-the-treatment-of-trauma-related-pain-in-adult-civilian-population
#6
JOURNAL ARTICLE
Alex Jabourian, Fanglong Dong, Kevin Mackey, Reza Vaezazizi, Troy W Pennington, Michael Neeki
Opiates are addicting and have a high potential for dependency. In the past decades, opiates remained the first-line pharmaceutical option of prehospital treatment for acute traumatic pain in the civilian population. Ketamine is an N-methyl-d-aspartate (NMDA) receptor antagonist that has analgesic properties and may serve as an alternative agent for the treatment of acute traumatic pain in prehospital settings. This study aims to assess the safety and efficacy of ketamine administration by paramedics in civilian prehospital settings for the treatment of acute traumatic pain...
August 5, 2020: Curēus
https://read.qxmd.com/read/32776812/ketamine-use-in-prehospital-and-hospital-treatment-of-the-acute-trauma-patient-a-joint-position-statement
#7
JOURNAL ARTICLE
Margaret M Morgan, Debra G Perina, Nicole M Acquisto, Mary E Fallat, John M Gallagher, Kathleen M Brown, Jeffrey Ho, Aaron Burnett, Julio Lairet, Dennis Rowe, Mark L Gestring
The American College of Surgeons Committee on Trauma (ACS-COT), the American College of Emergency Physicians (ACEP), the National Association of State EMS Officials (NASEMSO), the National Association of EMS Physicians (NAEMSP) and the National Association of EMTs (NAEMT) have previously offered varied guidance on the use of ketamine in trauma patients. The following consensus statement represents the collective positions of the ACS-COT, ACEP, NASEMSO, NAEMSP and NAEMT. This updated uniform guidance is intended for use by emergency medical services (EMS) personnel, EMS medical directors, emergency physicians, trauma surgeons, nurses and pharmacists in their treatment of the trauma patient in both the prehospital and hospital setting...
2021: Prehospital Emergency Care
https://read.qxmd.com/read/32775345/perioperative-management-of-alcohol-withdrawal-syndrome
#8
REVIEW
Alexander Lavinius Ungur, Tim Neumann, Friedrich Borchers, Claudia Spies
BACKGROUND: In the perioperative course, alcohol withdrawal syndrome (AWS) can occur in any setting, especially in aero-digestive and acute trauma surgery. Challenging issues are the overlap of other forms of delirium in perioperative and intensive care settings as well as general anesthesia masking the onset of withdrawal symptoms. In contrast to other etiologies of delirium, the pathophysiology and thus treatment strategy of AWS is different: the key point is the tolerance to GABAergic molecules of alcohol-dependent subjects resulting in central nervous hyperactivity once the effect of alcohol or other GABA-stimulating agents is decreased...
June 2020: Visceral Medicine
https://read.qxmd.com/read/32772873/intranasal-ketamine-as-an-adjunct-to-fentanyl-for-the-prehospital-treatment-of-acute-traumatic-pain-design-and-rationale-of-a-randomized-controlled-trial
#9
RANDOMIZED CONTROLLED TRIAL
Jason McMullan, Christopher Droege, Richard Strilka, Kimberly Hart, Christopher Lindsell
Objective : Acute pain management is fundamental in prehospital trauma care. Early pain control may decrease the risk of developing post-traumatic stress disorder (PTSD) and chronic pain. Fentanyl and ketamine are frequently used off-label, but there is a paucity of comparative data to guide decision-making about treatment of prehospital severe, acute pain. This trial will determine whether the addition of single dose of intranasal ketamine to fentanyl is more effective for the treatment of acute traumatic pain than administration of fentanyl alone...
July 2021: Prehospital Emergency Care
https://read.qxmd.com/read/32753538/association-between-traumatic-brain-injuries-and-ketamine-infusion-side-effects-following-combat-injury
#10
JOURNAL ARTICLE
Alexandra Victoria Kane, N A Giordano, J Tran, M L Kent, K B Highland
INTRODUCTION: Ketamine is a vital component for acute pain management in emergency trauma care for both civilian and military hospitals. This preliminary analysis examined whether combat-injured US service members sustaining traumatic brain injuries (TBI) experienced increased odds of ketamine side effects compared with those without TBI. METHODS: This preliminary analysis included combat-injured service members, ages ≥18 years with documented pain scores during the 24 hours before and 48 hours after receiving an intravenous ketamine infusion at Walter Reed National Military Medical Center (WRNMMC) between 2007 and 2014...
August 4, 2020: BMJ military health
https://read.qxmd.com/read/32690763/comparison-of-endoscopic-endotracheal-intubation-and-the-v-gel-supraglottic-airway-device-for-spontaneously-ventilating-new-zealand-white-rabbits-undergoing-ovariohysterectomy
#11
JOURNAL ARTICLE
Jessica Comolli, Rodney Schnellbacher, Hugues Beaufrere, Uriel Blas-Machado, Jane Quandt, Jörg Mayer, Stephen J Divers
BACKGROUND: Due to the technical difficulties with endotracheal intubation of rabbits, a prospective, randomised, controlled study was performed to compare a rabbit-specific supraglottic airway device (SGAD), the v-gel, with endoscopic endotracheal intubation (EEI) in spontaneously breathing rabbits undergoing ovariohysterectomy. METHODS: Fourteen adult female New Zealand white rabbits were randomly allocated to one of two groups based on the method of airway establishment: EEI or v-gel SGAD...
November 14, 2020: Veterinary Record
https://read.qxmd.com/read/32616209/the-emergence-of-ketamine-as-a-novel-treatment-for-posttraumatic-stress-disorder
#12
REVIEW
Adriana Feder, Sarah B Rutter, Daniela Schiller, Dennis S Charney
A serious lack of effective pharmacotherapeutic interventions for posttraumatic stress disorder (PTSD) raises the urgent need for the development of novel treatments. Ketamine-a noncompetitive glutamate N-methyl-d-aspartate (NMDA) receptor antagonist in use for decades as an anesthetic and analgesic agent-has more recently been demonstrated to have rapid-onset antidepressant effects in patients with treatment-resistant depression (TRD). In the present review of ketamine as an emerging novel pharmacotherapeutic intervention for chronic PTSD, we discuss findings from the first proof-of-concept, randomized clinical trial (RCT) of single-dose intravenous ketamine in patients with chronic PTSD, as well as open-label studies and current practice...
2020: Advances in Pharmacology
https://read.qxmd.com/read/32616206/chronic-stress-pathology-and-ketamine-induced-alterations-in-functional-connectivity-in-major-depressive-disorder-an-abridged-review-of-the-clinical-evidence
#13
REVIEW
Lynnette A Averill, Samar Fouda, James W Murrough, Chadi G Abdallah
A paradigm shift in the conceptualization of the neurobiology of depression and the serendipitous discovery of ketamine's rapid-acting antidepressant (RAAD) effects has ushered in a new era of innovative research and novel drug development. Since the initial discovery of ketamine's RAAD effects, multiple studies have supported its short-term efficacy for fast-tracked improvements in treatment-resistant depression. Evidence from MRI studies have repeatedly demonstrated functional connectivity alterations in stress- and trauma-related disorders suggesting this may be a viable biomarker of chronic stress pathology (CSP)...
2020: Advances in Pharmacology
https://read.qxmd.com/read/32569786/ketamine-metabolite-2r-6r-hydroxynorketamine-reverses-behavioral-despair-produced-by-adolescent-trauma
#14
JOURNAL ARTICLE
Greg I Elmer, Jenica D Tapocik, Cheryl L Mayo, Panos Zanos, Todd D Gould
Early life trauma dramatically increases the risk of developing major depressive disorder (MDD), and is associated with a markedly decreased adult treatment response to antidepressants. Novel treatment approaches are required to treat childhood trauma-associated MDD. Recent studies suggest that the (R,S)-ketamine (ketamine) metabolite, (2R,6R)-hydroxynorketamine (HNK), exerts fast- and long-lasting antidepressant-like effects without ketamine's NMDAR-inhibition-associated adverse side-effect profile. We investigated the therapeutic potential of (2R,6R)-HNK against behavioral despair produced by a novel live-predator stress exposure during adolescence...
September 2020: Pharmacology, Biochemistry, and Behavior
https://read.qxmd.com/read/32531068/ketamine-for-rapid-sequence-intubation-in-adult-trauma-patients-a-retrospective-observational-study
#15
JOURNAL ARTICLE
Josefine S Baekgaard, Trine G Eskesen, Jae Moo Lee, Camilla Ikast Ottosen, Katrine Bennett Gyldenkaerne, Jasmin Garoussian, Rasmus Ejlersgaard Christensen, Martin Sillesen, David R King, George C Velmahos, Lars S Rasmussen, Jacob Steinmetz
BACKGROUND: In the trauma population, ketamine is commonly used during rapid sequence induction. However, as ketamine has been associated with important side effects, this study sought to compare in-hospital mortality in trauma patients after induction with ketamine versus other induction agents. METHODS: We retrospectively identified adult trauma patients intubated in the pre-hospital phase or initially in the trauma bay at two urban level-1 trauma centers during a 2-year period using local trauma registries and medical records...
October 2020: Acta Anaesthesiologica Scandinavica
https://read.qxmd.com/read/32080000/effect-on-opioids-requirement-of-early-administration-of-intranasal-ketamine-for-acute-traumatic-pain
#16
RANDOMIZED CONTROLLED TRIAL
Wahid Bouida, Khaoula Bel Haj Ali, Houda Ben Soltane, Mohamed Amine Msolli, Hamdi Boubaker, Adel Sekma, Kaouthar Beltaief, Mohamed Habib Grissa, Mehdi Methamem, Riadh Boukef, Asma Belguith, Semir Nouira
OBJECTIVES: To evaluate the efficacy and safety of early administration of low-dose intranasal ketamine on reducing the need for opioid and nonopioid analgesic agents in emergency department (ED) patients with acute moderate to severe acute limbs' trauma pain. PATIENTS AND METHODS: This is a double-blind, randomized, prospective, controlled study conducted in the ED. The included patients were randomly assigned to intranasal pulverization of ketamine or placebo...
June 2020: Clinical Journal of Pain
https://read.qxmd.com/read/32074369/prehospital-use-of-ketamine-in-the-combat-setting-a-sub-analysis-of-patients-with-head-injuries-evaluated-in-the-prospective-life-saving-intervention-study
#17
MULTICENTER STUDY
Vikhyat S Bebarta, Alejandra G Mora, Emma K Bebarta, Lauren K Reeves, Joseph K Maddry, Steve G Schauer, Julio R Lairet
OBJECTIVES: Ketamine is used as an analgesic for combat injuries. Ketamine may worsen brain injury, but new studies suggest neuroprotection. Our objective was to report the outcomes of combat casualties with traumatic brain injury (TBI) who received prehospital ketamine. METHODS: This was a post hoc, sub-analysis of a larger prospective, multicenter study (the Life Saving Intervention study [LSI]) evaluating prehospital interventions performed in Afghanistan. A DoD Trauma Registry query provided disposition at discharge and outcomes to be linked with the LSI data...
January 7, 2020: Military Medicine
https://read.qxmd.com/read/32074304/tactical-combat-casualty-care-training-knowledge-and-utilization-in-the-us-army
#18
JOURNAL ARTICLE
Jennifer M Gurney, Caryn A Stern, Russ S Kotwal, Cord W Cunningham, Dallas R Burelison, Kirby R Gross, Harold R Montgomery, Edward H Whitt, Clinton K Murray, Zsolt T Stockinger, Frank K Butler, Stacy A Shackelford
INTRODUCTION: Tactical Combat Casualty Care (TCCC) is the execution of prehospital trauma skills in the combat environment. TCCC was recognized by the 2018 Department of Defense Instruction on Medical Readiness Training as a critical wartime task. This study examines the training, understanding, and utilization of TCCC principles and guidelines among US Army medical providers and examines provider confidence of medics in performing TCCC skills. MATERIALS AND METHODS: A cross-sectional survey, developed by members of the Committee on TCCC, was distributed to all US Army Physicians and Physician Assistants via anonymous electronic communication...
January 7, 2020: Military Medicine
https://read.qxmd.com/read/32067810/comparison-of-drugs-used-for-intubation-of-pediatric-trauma-patients
#19
COMPARATIVE STUDY
Martina Mudri, Andrew Williams, Fran Priestap, Jacob Davidson, Neil Merritt
PURPOSE: Rapid sequence intubation (RSI) drugs, such as propofol, affect clinical outcomes, but this has not been examined in the pediatric population. This descriptive study compares the outcomes associated with intubation drugs used in pediatric traumatic brain injury (TBI) patients. METHODS: A retrospective chart review and descriptive analysis of intubated TBI patients, ages 0-17, admitted to Children's Hospital London Health Sciences Centre (LHSC) from January 2006-December 2016 was performed...
May 2020: Journal of Pediatric Surgery
https://read.qxmd.com/read/32021982/the-efficacy-of-ketamine-administration-in-prehospital-pain-management-of-trauma-patients-a-systematic-review-and-meta-analysis
#20
JOURNAL ARTICLE
Mahmoud Yousefifard, Shaghayegh Askarian-Amiri, Seyedeh Niloufar Rafiei Alavi, Mostafa Sadeghi, Peyman Saberian, Alireza Baratloo, Mohammad Taghi Talebian
INTRODUCTION: Although previous articles and reviews suggest that ketamine might effectively manage pain in trauma patients, these articles have serious limitations. Accordingly, the current meta-analysis aims to investigate the efficacy of ketamine administration in prehospital pain management of trauma patients. METHOD: In the present meta-analysis, controlled human studies were included. An extensive search was conducted in electronic databases including Medline (via PubMed), Embase, Central, Scopus, Web of Science, and ProQuest, gathering data to the end of 2018...
2020: Archives of Academic Emergency Medicine
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