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Intravenous ketamine

Kirsten Boenigk, Ghislaine C Echevarria, Emmanuel Nisimov, Annelise E von Bergen Granell, Germaine E Cuff, Jing Wang, Arthur Atchabahian
BACKGROUND: The current opioid epidemic highlights the urgent need for effective adjuvant therapies to complement postoperative opioid analgesia. Intra-operative ketamine infusion has been shown to reduce postoperative opioid consumption and improve pain control in opioid-tolerant patients after spinal fusion surgery. Its efficacy for opioid-naïve patients, however, remains controversial. OBJECTIVE: We hypothesised that low-dose ketamine infusion after major spinal surgery reduces opioid requirements in opioid-tolerant patients, but not in opioid-naïve patients...
August 14, 2018: European Journal of Anaesthesiology
Mark Sinyor, Marissa Williams, Sue Belo, Beverley Orser, Margaret Vincent, Linda Mah, Carlos Zarate, Saulo Castel, Anthony J Levitt, Ayal Schaffer
BACKGROUND: Ketamine is known to rapidly reduce depressive symptoms and suicidal ideation (SI) in patients with major depressive disorder (MDD), but evidence is limited for its acceptability and effectiveness in "real-world" settings. This case series examines serial ketamine infusions in reducing SI and depression scores in adults with MDD admitted to a tertiary care hospital. METHODS: Five inpatients with MDD and SI admitted to hospital in Toronto, Canada received six infusions of 0...
July 29, 2018: Journal of Affective Disorders
Álvaro López-Díaz, José Luis Fernández-González
No abstract text is available yet for this article.
August 14, 2018: Journal of Clinical Psychopharmacology
Darsi N Pitchon, Amir C Dayan, Eric S Schwenk, Jaime L Baratta, Eugene R Viscusi
Pain control after orthopedic surgery is challenging. A multimodal approach provides superior analgesia with fewer side effects compared with opioids alone. This approach is particularly useful in light of the current opioid epidemic in the United States. Several new nonopioid agents have emerged into the market in recent years. New agents included in this review are intravenous acetaminophen, intranasal ketorolac, and newer nonsteroidal anti-inflammatory drugs, and the established medications ketamine and gabapentinoids...
September 2018: Anesthesiology Clinics
Samuel T Wilkinson, Rachel B Katz, Mesut Toprak, Ryan Webler, Robert B Ostroff, Gerard Sanacora
OBJECTIVE: Ketamine has emerged as a rapid-acting antidepressant, though controversy remains whether sufficient data exist to justify its use outside of research protocols. In October 2014, the authors' institution began providing ketamine as an off-label therapy on a case-by-case basis for patients unable to participate in research protocols. Here, the participant experience during 29 months of providing ketamine as a clinical treatment for severe and treatment-resistant mood disorders through February 2017 is described...
July 24, 2018: Journal of Clinical Psychiatry
Jared Langerman, Sotirios G Doukas, Hisashi Hasegawa, James Goodrich, Michael Lerner, Clarence Sasaki
Background: A malfunction or impairment of swallow function can potentiate aspiration events and interfere with both quality of life and survival. Establishing an animal model for swallow research would provide a better understanding of its pathophysiology and would also allow for the development and validation of physiologically based clinical interventions to improve swallow function. Two requirements define the ideal model for longitudinal exploration: 1) identification of species similar to human in form and function; and 2) provision for reliable and reproducible evoked swallow under general anesthesia and one that would also support a longitudinal study design...
June 2018: Laryngoscope Investigative Otolaryngology
Jasper van der Aart, Sandeep S V Golla, Marieke van der Pluijm, Lothar A Schwarte, Robert C Schuit, Pieter J Klein, Athanasios Metaxas, Albert D Windhorst, Ronald Boellaard, Adriaan A Lammertsma, Bart N M van Berckel
BACKGROUND: Efforts to develop suitable positron emission tomography (PET) tracers for the ion channel site of human N-methyl-D-aspartate (NMDA) receptors have had limited success. [18 F]PK-209 is a GMOM derivative that binds to the intrachannel phencyclidine site with high affinity and selectivity. Primate PET studies have shown that the volume of distribution in the brain was reduced by administration of the NMDA receptor antagonist MK-801, consistent with substantial specific binding...
July 27, 2018: EJNMMI Research
Lucie Bartova, Konstantinos Papageorgiou, Ivan Milenkovic, Markus Dold, Ana Weidenauer, Matthaeus Willeit, Dietmar Winkler, Siegfried Kasper
Rapid anti-suicidal and antidepressant effects of ketamine have repeatedly been confirmed in unipolar and bipolar depression. Although meaningful antidepressant efficacy of ketamine has also been shown in depressed patients with a history of psychotic symptoms, its administration in psychotic disorders has largely been neglected due to its potential to exacerbate dissociative or psychotic symptoms. Presenting a case of a young female inpatient suffering from schizophrenia with a severe post-psychotic depression, we demonstrate a robust anti-suicidal and antidepressant effect of S-ketamine infusions administered thrice weekly for 3 weeks in total...
July 2, 2018: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
Nicholas Karlow, Charles H Schlaepfer, Carolyn R T Stoll, Michelle Doering, Christopher R Carpenter, Graham A Colditz, Sergey Motov, Joshua Miller, Evan S Schwarz
BACKGROUND: Opioids are commonly prescribed in the emergency department (ED) for the treatment of acute pain. Analgesic alternatives are being explored in response to an epidemic of opioid misuse. Low-dose ketamine (LDK) is one opioid alternative for the treatment of acute pain in the ED. OBJECTIVES: This systematic review and meta-analysis sought to quantify whether LDK is an effective and safe opioid alternative for acute pain reduction in adults in the ED setting...
July 17, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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
Mehrdad Esmailian, Mahboubeh Koushkian Esfahani, Farhad Heydari
Introduction: Efficient treatment of asthma can play an important role in controlling asthma attacks, rapid recovery and decrease of patient mortality. Therefore, in the present study the therapeutic effect of low-dose ketamine is evaluated in patients with acute asthma attack. Methods: In the present single-blind, randomized clinical trial with placebo control, the effect of low-dose intravenous ketamine in treating 18 to 85 year-old asthmatic patients who presented to the emergency department was evaluated...
2018: Emergency (Tehran, Iran)
Nathan J Smischney, Emily M Pollard, Asha U Nookala, Oludare O Olatoye
BACKGROUND Serotonin syndrome is a life-threatening condition that can lead to neurologic complications and is associated with the use of serotonergic medications. As the use of antidepressant medications has increased, the incidence of perioperative serotonin syndrome has transitioned from a rare diagnosis to one that should be considered as a differential diagnosis for any patient displaying signs of neuroexcitation. CASE REPORT A 70-year-old man (ASA 2) with a history of vestibular migraines (treated with venlafaxine), gastroesophageal reflux disease, and benign prostatic hyperplasia presented to our institution for photoselective vaporization of the prostate...
July 16, 2018: American Journal of Case Reports
Kathryn R Cullen, Palistha Amatya, Mark G Roback, Christina Sophia Albott, Melinda Westlund Schreiner, Yanan Ren, Lynn E Eberly, Patricia Carstedt, Ali Samikoglu, Meredith Gunlicks-Stoessel, Kristina Reigstad, Nathan Horek, Susannah Tye, Kelvin O Lim, Bonnie Klimes-Dougan
BACKGROUND: Novel interventions for treatment-resistant depression (TRD) in adolescents are urgently needed. Ketamine has been studied in adults with TRD, but little information is available for adolescents. This study investigated efficacy and tolerability of intravenous ketamine in adolescents with TRD, and explored clinical response predictors. METHODS: Adolescents, 12-18 years of age, with TRD (failure to respond to two previous antidepressant trials) were administered six ketamine (0...
July 13, 2018: Journal of Child and Adolescent Psychopharmacology
Kenta Furutani, Mari Matsuhashi, Hiroyuki Deguchi, Yusuke Mitsuma, Nobuko Ohashi, Hiroshi Baba
BACKGROUND: It is believed that ketamine does not affect motor-evoked potential amplitude, whereas various anesthetic drugs attenuate the amplitude of transcranial motor-evoked potential. However, we encountered a patient with marked attenuation of motor-evoked potential amplitude after intravenous bolus administration of ketamine. CASE PRESENTATION: A 15-year-old Japanese girl with a diagnosis of adolescent idiopathic scoliosis was admitted to our hospital to undergo posterior spinal fusion at T4-L3...
July 13, 2018: Journal of Medical Case Reports
Luca Bellini, Giulia Maria De Benedictis
Neuromuscular blocking agents (NMBAs) are commonly used in experimental laparoscopy in swine undergoing carbon dioxide pneumoperitoneum. Hypercapnia may be present and may prolong NMBAs' pharmacologic activity. The aim of this study is to evaluate the effect of permissive hypercapnia on the neuromuscular blockade of atracurium in swine. Six Large White swine weighing 30.5 ± 1.6 kg were sedated with intramuscular ketamine and medetomidine, after which anaesthesia was induced with propofol and maintained with sevoflurane...
2018: PloS One
Ahmed Khalil, Swaytha Ganesh, Christopher Hughes, Amit D Tevar, John J Hasche, Stephen Esper, Abhinav Humar
BACKGROUND: Enhanced recovery after surgery (ERAS) protocol has proven to be effective in many surgery fields in controlling pain and promoting early recovery. Application of the (ERAS) protocol in living donor liver patients is a new step to promote early recovery. METHODS: We analyzed outcomes in two groups. Group A included the living donors who had the ERAS protocol applied (n = 30), and Group B included donors who had their surgery before the ERAS protocol (n = 30)...
July 2, 2018: Clinical Transplantation
Hakan Akelma, Ebru Tarikçi Kiliç, Fikret Salik, Ayhan Kaydu
Objectives: To compare the effects of ketamine-fentanyl (KF) and ketamine-midazolam (KM) combinations on hemodynamic parameters, recovery properties, pain, and side effects in pediatric patients undergoing extracorporeal shock wave lithotripsy (ESWL) procedure. Methodology: In this double-blinded, randomized trial, 60 pediatric patients aged between 1 and 13 years with American Society of Anesthesiologists physical status Classes I and II, who scheduled for ESWL procedure, were included in the study...
April 2018: Anesthesia, Essays and Researches
Cheol Lee, Juhwan Lee, Gilho Lee, Hayeong Lee, Zhou Shicheng, Jihyo Hwang
BACKGROUND: It has been known that anesthetic adjuvants such as dexamethasone or ketamine might change mood. This study aimed to investigate the effects of a single dose of each drug individually along with their combined usage on postoperative mood changes in patients undergoing gynecologic surgery. METHODS: Two hundred ninety-seven patients randomly allocated were divided into three groups. Group K (n = 99) received a single dose of ketamine (0.5 mg/kg iv); group D (n = 99) received a single dose of dexamethasone (0...
August 2018: Psychopharmacology
Jie Liu, Yong Wang, Wuhua Ma
INTRODUCTION: Perioperative shivering during cesarean sections (CSs) under neuraxial anesthesia (NA) is clinically common but often under-treated. It may prominently increase oxygen consumption, which can be catastrophic for parturients with ischemic cardiovascular disease. Thus, the prevention and treatment of shivering may be of great significance in parturients. The purpose of this systematic review was to investigate the effectiveness of several drugs on shivering prevention and treatment during CSs under NA...
June 26, 2018: Minerva Anestesiologica
Koichi Yuki, Sandra Lee, Steven J Staffa, James A DiNardo
STUDY OBJECTIVE: Appropriate agent selection in patients with congenital heart disease (CHD) undergoing cardiac surgery and catheterization have been extensively reviewed in the literature. To date, there has not been an analysis of induction drug choices made in a large group of CHD patients undergoing non-cardiac procedures and intraoperative events. The primary objective was to characterize induction agent selection in CHD patients undergoing non-cardiac procedures and examine its association with intraoperative events...
June 20, 2018: Journal of Clinical Anesthesia
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