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“Ketamine” AND “trauma”

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https://www.readbyqxmd.com/read/30118637/trends-in-prehospital-analgesia-administration-by-us-forces-from-2007-through-2016
#1
Steven G Schauer, Jason F Naylor, Joseph K Maddry, Carmen Hinojosa-Laborde, Michael D April
BACKGROUND: Tactical Combat Casualty Care (TCCC) guidelines regarding prehospital analgesia agents have evolved. The guidelines stopped recommending intramuscular (IM) morphine in 1996, recommending only intravenous (IV) routes. In 2006, the guidelines recommended oral transmucosal fentanyl citrate (OTFC), and in 2012 it added ketamine via all routes. It remains unclear to what extent prehospital analgesia administered on the battlefield adheres to these guidelines. We seek to describe trends in analgesia administration patterns on the battlefield during 2007-2016...
August 17, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/30050444/what-acute-stress-protocols-can-tell-us-about-ptsd-and-stress-related-neuropsychiatric-disorders
#2
REVIEW
Laura Musazzi, Paolo Tornese, Nathalie Sala, Maurizio Popoli
Posttraumatic stress disorder (PTSD), the fifth most prevalent mental disorder in the United States, is a chronic, debilitating mental illness with as yet limited options for treatment. Hallmark symptoms of PTSD include intrusive memory of trauma, avoidance of reminders of the event, hyperarousal and hypervigilance, emotional numbing, and anhedonia. PTSD is often triggered by exposure to a single traumatic experience, such as a traffic accident, a natural catastrophe, or an episode of violence. This suggests that stressful events have a primary role in the pathogenesis of the disorder, although genetic background and previous life events are likely involved...
2018: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/30031556/the-characteristics-and-prevalence-of-agitation-in-an-urban-county-emergency-department
#3
James R Miner, Lauren R Klein, Jon B Cole, Brian E Driver, Johanna C Moore, Jeffrey D Ho
STUDY OBJECTIVE: We seek to determine the characteristics and prevalence of agitation among patients in an urban county emergency department (ED). METHODS: This was a prospective observational study of ED patients at an urban Level I trauma center. All ED patients were screened during daily randomized 8-hour enrollment periods. Adult agitated patients, defined as having an altered mental status score greater than 1, were included. Trained research volunteers collected demographics and baseline data, including the presenting altered mental status score, use and type of restraints, and whether any initial sedative was given...
July 18, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/30026698/psychedelic-assisted-psychotherapy-a-paradigm-shift-in-psychiatric-research-and-development
#4
Eduardo Ekman Schenberg
Mental disorders are rising while development of novel psychiatric medications is declining. This stall in innovation has also been linked with intense debates on the current diagnostics and explanations for mental disorders, together constituting a paradigmatic crisis. A radical innovation is psychedelic-assisted psychotherapy (PAP): professionally supervised use of ketamine, MDMA, psilocybin, LSD and ibogaine as part of elaborated psychotherapy programs. Clinical results so far have shown safety and efficacy, even for "treatment resistant" conditions, and thus deserve increasing attention from medical, psychological and psychiatric professionals...
2018: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/30018022/effect-of-acute-restraint-stress-in-a-polytrauma-rat-model
#5
Françoise Arnaud, Georgina Pappas, Ye Chen, Eric Maudlin-Jeronimo, Richard McCarron
INTRODUCTION: A stressful environment may contribute to poor outcomes after TBI. The current study evaluates the impact of acute stress in a polytrauma rat model. METHODS: Rats were stressed by a 45-minute immobilization period before instrumentation under ketamine (t1). Polytrauma was produced by blast overpressure and controlled hemorrhage (t2). Rats were euthanized immediately after a 3 h simulated Medevac-transport time (t3) or after 72 h post-trauma (t4)...
July 6, 2018: Neuroscience Letters
https://www.readbyqxmd.com/read/30013730/chronic-postsurgical-pain-current-evidence-for-prevention-and-management
#6
REVIEW
Parineeta Thapa, Pramote Euasobhon
Chronic postsurgical pain (CPSP) is an unwanted adverse event in any operation. It leads to functional limitations and psychological trauma for patients, and leaves the operative team with feelings of failure and humiliation. Therefore, it is crucial that preventive strategies for CPSP are considered in high-risk operations. Various techniques have been implemented to reduce the risk with variable success. Identifying the risk factors for each patient and applying a timely preventive strategy may help patients avoid the distress of chronic pain...
July 2018: Korean Journal of Pain
https://www.readbyqxmd.com/read/29965991/prehospital-ultrasound-guided-nerve-blocks-improve-reduction-feasibility-of-dislocated-extremity-injuries-compared-to-systemic-analgesia-a-randomized-controlled-trial
#7
Benedikt Büttner, Ashham Mansur, Matthias Kalmbach, José Hinz, Thomas Volk, Karoly Szalai, Markus Roessler, Ingo Bergmann
BACKGROUND: Out-of-hospital analgosedation in trauma patients is challenging for emergency physicians due to associated complications. We compared peripheral nerve block (PNB) with analgosedation (AS) as an analgetic approach for patients with isolated extremity injury, assuming that prehospital required medical interventions (e.g. reduction, splinting of dislocation injury) using PNB are less painful and more feasible compared to AS. METHODS: Thirty patients (aged 18 or older) were randomized to receive either ultrasound-guided PNB (10 mL prilocaine 1%, 10 mL ropivacaine 0...
2018: PloS One
https://www.readbyqxmd.com/read/29944524/ketamine-as-a-rapid-sequence-induction-agent-in-the-trauma-population-a-systematic-review
#8
Josefine S Baekgaard, Trine G Eskesen, Martin Sillesen, Lars S Rasmussen, Jacob Steinmetz
The choice of drug used to facilitate endotracheal intubation in trauma patients during rapid sequence induction (RSI) may have an impact on survival. Ketamine is commonly used in the hemodynamically unstable trauma patient although it has been associated with side effects. This review sought to investigate whether ketamine should be preferred over other induction agents for RSI in trauma patients. PubMed, Embase, and the Cochrane Library were systematically searched on September 19, 2016 for studies reporting RSI of adult trauma patients with ketamine compared with another induction agent (etomidate, propofol, thiopental, or midazolam)...
June 25, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29888875/ketamine-use-for-rapid-sequence-intubation-in-australian-and-new-zealand-emergency-departments-from-2010-to-2015-a-registry-study
#9
Ian Ferguson, Hatem Alkhouri, Toby Fogg, Anders Aneman
OBJECTIVE: This study aimed to quantify the proportion of patients undergoing rapid sequence intubation using ketamine in Australian and New Zealand EDs between 2010 and 2015. METHODS: The Australian and New Zealand Emergency Department Airway Registry is a multicentre airway registry prospectively capturing data from 43 sites. Data on demographics and physiology, the attending staff and indication for intubation were recorded. The primary outcome was the annual percentage of patients intubated with ketamine...
June 11, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29794290/efficacy-and-safety-of-epidural-continuous-perineural-infusion-and-adjuvant-analgesics-for-acute-postoperative-pain-after-major-limb-amputation-a-systematic-review
#10
REVIEW
Hanna von Plato, Vesa Kontinen, Katri Hamunen
BACKGROUND AND AIMS: Treatment of pain following major limb amputations is often a clinical challenge in a patient population consisting mainly of elderly with underlying diseases. Literature on management of acute post-amputation pain is scarce. We performed a systematic review on this topic to evaluate the efficacy and safety of analgesic interventions for acute pain following major limb amputation. METHODS: A literature search was performed in PubMed, Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews using the following key words: [(amputation) AND (pain OR analgesi* OR pain relief)] AND (acute OR postoperative)...
January 26, 2018: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29794269/wireless-peripheral-nerve-stimulation-for-complex-regional-pain-syndrome-type-i-of-the-upper-extremity-a-case-illustration-introducing-a-novel-technology
#11
Daniel Herschkowitz, Jana Kubias
Background Complex regional pain syndrome (CRPS) is a debilitating painful disorder, cryptic in its pathophysiology and refractory condition with limited therapeutic options. Type I CRPS with its variable relationship to trauma has often no discernible fractures or nerve injuries and remains enigmatic in its response to conservative treatment as well as the other limited interventional therapies. Neuromodulation in the form of spinal cord and dorsal root ganglion stimulation (SCS, DRGS) has shown encouraging results, especially of causalgia or CRPS I of lower extremities...
July 26, 2018: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29782960/the-acute-and-residual-effects-of-escalating-analgesic-range-doses-of-ketamine-on-driving-performance-a-simulator-study
#12
Amie C Hayley, Maja Green, Luke A Downey, Con K K Stough, Michael Keane, Brook Shiferaw, Panagiota Kostakis, Yahya Shehabi
Ketamine hydrochloride elicits potent psychotomimetic and neurobehavioural effects which make it incompatible with driving; however, the direct effect on driving performance is yet to be assessed. Using an open label, within-subjects protocol, 15 males and 5 females (mean age = 30.8 years) were administered three fixed, stepwise increasing sub-anaesthetic doses of intravenous (IV) ketamine solution [(i) 8 mg/h IV infusion plus 30 mg bolus, (ii) 12 mg/h IV infusion and (iii) 20 mg/h infusion]. Whole blood ketamine and norketamine concentrations were determined at each treatment step and at 2 h post-infusion...
August 30, 2018: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/29775117/intravenous-low-dose-ketamine-provides-greater-pain-control-compared-to-fentanyl-in-a-civilian-prehospital-trauma-system-a-propensity-matched-analysis
#13
E Stein Bronsky, Catherine Koola, Alessandro Orlando, Diane Redmond, Cecile D'Huyvetter, Heather Sieracki, Allen Tanner, Ray Fowler, Charles Mains, David Bar-Or
OBJECTIVE: A few studies report comparable analgesic efficacy between low-dose ketamine and opioids such as morphine or fentanyl; however, limited research has explored the safety and effectiveness of intravenous low-dose ketamine as a primary analgesic in a civilian prehospital setting. The objective of this study is to compare pain control between low-dose ketamine and fentanyl when administered intravenously (IV) for the indication of severe pain. METHODS: This was a retrospective, observational review of prehospital adult patients (≥18 years) who presented with severe pain (numeric rating scale, 7-10) and were treated solely with either low-dose ketamine IV or fentanyl IV between January 1, 2014 and December 31, 2016...
May 18, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29696126/acute-pain-management-in-emergency-department-low-dose-ketamine-versus-morphine-a-randomized-clinical-trial
#14
Babak Mahshidfar, Mani Mofidi, Maryam Fattahi, Davood Farsi, Peyman Hafezi Moghadam, Saeed Abbasi, Mahdi Rezai
Background: Ketamine, as an opium alternative, has been proposed for pain relief in the emergency department (ED). Objectives: This study was carried out to compare low dose ketamine (LDK) with morphine for pain relief in trauma patients. Methods: In this randomized double-blinded clinical trial, 300 trauma patients from the ED of 2 teaching hospitals in Tehran, Iran were enrolled and randomly divided into 2 equal groups. The 1st group received 0...
December 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29607659/ketamine-as-an-analgesic-adjuvant-in-adult-trauma-intensive-care-unit-patients-with-rib-fracture
#15
Mary K Walters, Joseph Farhat, James Bischoff, Mary Foss, Cory Evans
BACKGROUND: Rib fracture associated pain is difficult to control. There are no published studies that use ketamine as a therapeutic modality to reduce the amount of opioid to control rib fracture pain. OBJECTIVE: To examine the analgesic effects of adjuvant ketamine on pain scale scores in trauma intensive care unit (ICU) rib fracture. METHODS: This retrospective, case-control cohort chart review evaluated ICU adult patients with a diagnosis of ≥1 rib fracture and an Injury Severity Score >15 during 2016...
September 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29605036/ketamine-versus-hydromorphone-patient-controlled-analgesia-for-acute-pain-in-trauma-patients
#16
Sheila C Takieddine, Christopher A Droege, Neil Ernst, Molly E Droege, Megan Webb, Richard D Branson, Travis W Gerlach, Bryce R H Robinson, Jay A Johannigman, Eric W Mueller
BACKGROUND: It is unknown whether ketamine administered via patient-controlled analgesia (PCA) provides adequate analgesia while reducing opioid consumption in the traumatically injured patient. Differences in opioid consumption, pain scores, and adverse effects between ketamine and hydromorphone PCA were studied. MATERIALS AND METHODS: This is an investigator-initiated, single-center, double-blinded, randomized, pilot trial conducted from 2014 to 2016 at a level 1 trauma center...
May 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29569703/histopathological-changes-in-the-choroid-plexus-after-traumatic-brain-injury-in-the-rats-a-histologic-and-immunohistochemical-study
#17
Hüseyin Özevren, Engin Deveci, Mehmet Cudi Tuncer
Traumatic brain injury (TBI) is in part associated with the disruption of the blood-brain barrier. In this study, we analyzed the histopathological changes in E-cadherin and VEGF expression after traumatic brain injury in rats. The rats were divided into 2 groups as the control and the trauma groups. Sprague-Dawley rats were subjected to traumatic brain injury with a weight-drop device using 300 g⁻¹ m weight-height impact. After 5 days of traumatic brain injury, blood samples were taken under ketamine hydroxide anesthesia and biochemical analyzes were performed...
March 23, 2018: Folia Morphologica (Warsz)
https://www.readbyqxmd.com/read/29563072/d-serine-is-a-potential-biomarker-for-clinical-response-in-treatment-of-post-traumatic-stress-disorder-using-r-s-ketamine-infusion-and-timber-psychotherapy-a-pilot-study
#18
RANDOMIZED CONTROLLED TRIAL
Basant Pradhan, Ludmil Mitrev, Ruin Moaddell, Irving W Wainer
Post-traumatic stress disorder (PTSD) is a chronic and debilitating condition that is often refractory to standard frontline antidepressant therapy. A promising new approach to PTSD therapy is administration of a single sub-anesthetic dose of (R,S)-ketamine (Ket). The treatment produces rapid and significant therapeutic response, which lasts for only 4-7 days. In one of our studies, the mean duration of response was increased to 33 days when Ket administration was combined with a mindfulness-based cognitive therapy, Trauma Interventions using Mindfulness Based Extinction and Reconsolidation (TIMBER)...
July 2018: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/29530653/implementation-of-a-clinical-bundle-to-reduce-out-of-hospital-peri-intubation-hypoxia
#19
Jeffrey L Jarvis, John Gonzales, Danny Johns, Lauren Sager
STUDY OBJECTIVE: Peri-intubation hypoxia is an important adverse event of out-of-hospital rapid sequence intubation. The aim of this project is to determine whether a clinical bundle encompassing positioning, apneic oxygenation, delayed sequence intubation, and goal-directed preoxygenation is associated with decreased peri-intubation hypoxia compared with standard out-of-hospital rapid sequence intubation. METHODS: We conducted a retrospective, before-after study using data from a suburban emergency medical services (EMS) system in central Texas...
March 9, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29443860/a-novel-rat-model-of-extremity-trauma-for-prehospital-pain-management-research
#20
Lusha Xiang, Harold G Klemcke, Nathan A Wienandt, Kathy L Ryan, Carmen Hinojosa-Laborde
BACKGROUND: Pain management is important in prehospital care of patients with extremity trauma (ET). The goal of this study was to establish a rat model of ET for prehospital pain research and validate it using pain behaviors and analgesics. METHODS: Rats were anesthetized using isoflurane, and ET was induced in one hindlimb via clamping retrofemoral tissues for 30 seconds, followed by closed fibula fracture. Rats regained consciousness after ET. Pain responses in the injured hindlimb to thermal hyperalgesia (paw withdrawal latency [PWL]), mechanical allodynia (paw withdrawal pressure [PWP]), and weight bearing (WB) were determined before and 90 minutes after ET...
July 2018: Journal of Trauma and Acute Care Surgery
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