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https://www.readbyqxmd.com/read/28216871/role-of-ketamine-and-methadone-as-adjunctive-therapy-in-complex-pain-management-a-case-report-and-literature-review
#1
Wasek Faisal, Judith Jacques
Assessment and management of complex cancer pain always remains a major challenge for any palliative care team, given its heterogeneity of underlying pathophysiology and limitations of any pharmacotherapy. Here, we present a case of complex pain management in a young patient with a life-limiting illness, highlighting the issues of organic and nonorganic contributors of pain and provide some insight into the role of ketamine and methadone as adjunctive therapy to opioid analgesics. A brief literature review is also done to provide the context of use of these adjunctive drugs in this setting...
January 2017: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/28158165/ketamine-an-update-on-cellular-and-subcellular-mechanisms-with-implications-for-clinical-practice
#2
Gary J Iacobucci, Ognjen Visnjevac, Leili Pourafkari, Nader Djalal Nader
BACKGROUND: Ketamine is one of the oldest hypnotic agents used to provide an anesthetic agent with analgesic properties and minimal suppressive effects on respiration. The ability of ketamine in modulating glutamatergic (N-methyl D-aspartate) pain receptors has made this anesthetic drug a new option for the management of patients with chronic pain syndromes. Further preclinical and clinical findings suggest ketamine may have wide ranging effects on both cognition and development. Recent advances have revealed an unprecedented role for ketamine in the acute management of depression...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28132604/management-of-peripheral-neuropathy-induced-by-chemotherapy-in-adults-with-cancer-a-review
#3
Nijmeh Al-Atiyyat, Abdullah Obaid
AIM: To identify which of the examined agents or modalities were effective in the management of chemotherapy-induced peripheral neuropathy (CIPN). METHODS: PubMed, CINAHL, Medline, Science Direct and Ovid databases were used to search keywords. The literature search identified 59 potentially relevant studies; after removing duplicates and reviewing titles a total of 26 articles were examined. In the end, a total of 18 studies met the inclusion criteria. FINDINGS: The preliminary data for using lafutidine, acupuncture and sweet bee venom pharmacopuncture indicate that they may be useful in CIPN management...
January 2, 2017: International Journal of Palliative Nursing
https://www.readbyqxmd.com/read/28132136/multimodal-analgesia-current-concepts-and-acute-pain-considerations
#4
REVIEW
Erik M Helander, Bethany L Menard, Chris M Harmon, Ben K Homra, Alexander V Allain, Gregory J Bordelon, Melville Q Wyche, Ira W Padnos, Anna Lavrova, Alan D Kaye
PURPOSE OF REVIEW: Management of acute pain following surgery using a multimodal approach is recommended by the American Society of Anesthesiologists whenever possible. In addition to opioids, drugs with differing mechanisms of actions target pain pathways resulting in additive and/or synergistic effects. Some of these agents include alpha 2 agonists, NMDA receptor antagonists, gabapentinoids, dexamethasone, NSAIDs, acetaminophen, and duloxetine. RECENT FINDINGS: Alpha 2 agonists have been shown to have opioid-sparing effects, but can cause hypotension and bradycardia and must be taken into consideration when administered...
January 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28118213/a-case-report-subanesthetic-ketamine-infusion-for-treatment-of-cancer-related-pain-produces-urinary-urge-incontinence
#5
Barbara A Vickers, Wayne Lee, Joann Hunsberger
Oncology patients undergoing treatment can experience substantial pain related to their disease or prescribed therapy. Ketamine infusions at subanesthetic doses have been used at our institution to supplement the pain management regimens of 262 patients. We present 2 cases in which young adult patients being treated with subanesthetic ketamine for cancer-related pain experienced urinary urgency and incontinence after initiation or increase of the ketamine infusion. This adverse effect has not been reported previously at this dosing range...
January 23, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28067704/intravenous-ketamine-infusions-for-neuropathic-pain-management-a-promising-therapy-in-need-of-optimization
#6
Dermot P Maher, Lucy Chen, Jianren Mao
Intravenous ketamine infusions have been used extensively to treat often-intractable neuropathic pain conditions. Because there are many widely divergent ketamine infusion protocols described in the literature, the variation in these protocols presents a challenge for direct comparison of one protocol with another and in discerning an optimal protocol. Careful examination of the published literature suggests that ketamine infusions can be useful to treat neuropathic pain and that certain characteristics of ketamine infusions may be associated with better clinical outcomes...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28025837/ketamine-infusions-for-treatment-refractory-headache
#7
Jared L Pomeroy, Michael J Marmura, Stephanie J Nahas, Eugene R Viscusi
BACKGROUND: Management of chronic migraine (CM) or new daily persistent headache (NDPH) in those who require aggressive outpatient and inpatient treatment is challenging. Ketamine has been suggested as a new treatment for this intractable population. METHODS: This is a retrospective review of 77 patients who underwent administration of intravenous, subanesthetic ketamine for CM or NDPH. All patients had previously failed aggressive outpatient and inpatient treatments...
February 2017: Headache
https://www.readbyqxmd.com/read/27927117/pain-management-for-chemotherapy-induced-oral-mucositis
#8
Michelle Bennett
The number of children and young people diagnosed with cancer is increasing every year. Pain is a significant side effect of disease, surgery and treatments including chemotherapy. After a course of intensive chemotherapy, some children develop oral mucositis, a debilitating condition causing bleeding, pain and inflammation. Moderate and severe mucositis pain is treated with continued good oral hygiene and parenteral analgesia. The aim of this article is to identify challenges in managing chemotherapy-induced oral mucositis pain in children, and to highlight the benefits of adding ketamine as an adjuvant analgesic...
December 8, 2016: Nursing Children and Young People
https://www.readbyqxmd.com/read/27920502/physicochemical-stability-of-ternary-admixtures-of-butorphanol-ketamine-and-droperidol-in-polyolefin-bags-for-patient-controlled-analgesia-use
#9
Baoxia Fang, Linhai Wang, Junfeng Gu, Fuchao Chen, Xiao-Ya Shi
BACKGROUND: Delivery of drug admixtures by intravenous patient-controlled analgesia is a common practice for the management of postoperative pain; however, analytical confirmation of the compatibility and stability of butorphanol tartrate, ketamine hydrochloride, and droperidol combined in ternary admixtures is not available. METHODS: Butorphanol tartrate, ketamine hydrochloride, and droperidol have been examined for compatibility and stability when combined with 0...
2016: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/27919589/preincisional-and-postoperative-epidural-morphine-ropivacaine-ketamine-and-naloxone-treatment-for-postoperative-pain-management-in-upper-abdominal-surgery
#10
Hou-Chuan Lai, Chung-Bao Hsieh, Chih-Shung Wong, Chun-Chang Yeh, Zhi-Fu Wu
OBJECTIVE(S): Previous studies have shown that preincisional epidural morphine, bupivacaine, and ketamine combined with epidural anesthesia (EA) and general anesthesia (GA) provided pre-emptive analgesia for upper abdominal surgery. Recent studies reported that ultralow-dose naloxone enhanced the antinociceptive effect of morphine in rats. This study investigated the benefits of preincisional and postoperative epidural morphine + ropivacaine + ketamine + naloxone (M + R + K + N) treatment for achieving postoperative pain relief in upper abdominal surgery...
September 2016: Acta Anaesthesiologica Taiwanica: Official Journal of the Taiwan Society of Anesthesiologists
https://www.readbyqxmd.com/read/27891453/efficacy-of-ketamine-as-an-adjunct-to-local-anesthesia-in-the-surgical-removal-of-impacted-mandibular-third-molars-a-split-mouth-prospective-controlled-clinical-study
#11
Anand Shah, Rajshekhar Halli, Yash Merchant, Rajesh Kshirsagar, Jyotsana Khurana
INTRODUCTION: The removal of impacted teeth is one of the most common procedures performed by oral and maxillofacial surgeons. Reduction of discomfort post-operatively and efficient local anesthesia are imperative for success in surgical practice. At sub-anesthetic doses, ketamine has a noticeable analgesic action, which can be used to supplement local anesthesia with minimal side effects. AIM: To assess the efficacy of low-dose ketamine as an adjunct to local anesthesia in the management of pain, swelling and trismus after surgical removal of impacted mandibular third molars...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27851493/1858-intravenous-ketamine-for-refractory-sickle-cell-pain-crisis-management-in-the-medical-icu
#12
Aesha Jobanputra, Deepali Dixit, Sabiha Hussain
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27847695/combined-ketamine-tramadol-subcutaneous-wound-infiltration-for-multimodal-postoperative-analgesia-a-double-blinded-randomized-controlled-trial-after-renal-surgery
#13
Mohammad Reza Khajavi, Marzieh Navardi, Reza Shariat Moharari, Pejman Pourfakhr, Narjes Khalili, Farhad Etezadi, Farsad Imani
BACKGROUND: Pain is an important consideration after renal surgery. A multimodal approach to postoperative pain management could enhance analgesia by risking fewer side effects after surgery. OBJECTIVES: The aim of this study was to evaluate the clinical efficacy of the subcutaneous infiltration of ketamine and tramadol at the incision site to reduce postoperative pain. METHODS: Sixty-four patients between 18 and 80 years old who were scheduled for elective renal surgery were enrolled in a double-blind randomized controlled study...
October 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27832755/experience-of-the-use-of-ketamine-to-manage-opioid-withdrawal-in-an-addicted-woman-a-case-report
#14
Laurence Lalanne, Chloe Nicot, Jean-Philippe Lang, Gilles Bertschy, Eric Salvat
BACKGROUND: Opioids are good painkillers, but many patients treated with opioids as painkillers developed a secondary addiction. These patients need to stop misusing opioids, but the mild-to-severe clinical symptoms associated with opioid withdrawal risk increasing their existing pain. In such cases, ketamine, which is used by anaesthetists and pain physicians to reduce opioid medication, may be an effective agent for managing opioid withdrawal. CASE PRESENTATION: We describe the case of a woman who developed a severe secondary addiction to opioids in the context of lombo-sciatic pain...
November 10, 2016: BMC Psychiatry
https://www.readbyqxmd.com/read/27828892/exploring-opioid-sparing-multimodal-analgesia-options-in-trauma-a-nursing-perspective
#15
Denise Sullivan, Mary Lyons, Robert Montgomery, Ann Quinlan-Colwell
Challenges with opioids (e.g., adverse events, misuse and abuse with long-term administration) have led to a renewed emphasis on opioid-sparing multimodal management of trauma pain. To assess the extent to which currently available evidence supports the efficacy and safety of various nonopioid analgesics and techniques to manage trauma pain, a literature search of recently published references was performed. Additional citations were included on the basis of authors' knowledge of the literature. Effective options for opioid-sparing analgesics include oral and intravenous (IV) acetaminophen; nonsteroidal anti-inflammatory drugs available via multiple routes; and anticonvulsants, which are especially effective for neuropathic pain associated with trauma...
November 2016: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/27737513/pharmacologic-interventions-for-treating-phantom-limb-pain
#16
REVIEW
Maria Jenelyn M Alviar, Tom Hale, Monalisa Dungca
BACKGROUND: This is an updated version of the original Cochrane review published in Issue 12, 2011. Phantom limb pain (PLP) is pain that arises in the missing limb after amputation and can be severe, intractable, and disabling. Various medications have been studied in the treatment of phantom pain. There is currently uncertainty in the optimal pharmacologic management of PLP. OBJECTIVES: This review aimed to summarise the evidence of effectiveness of pharmacologic interventions in treating PLP...
October 14, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27703629/comparison-of-effects-of-intraoperative-nefopam-and-ketamine-infusion-on-managing-postoperative-pain-after-laparoscopic-cholecystectomy-administered-remifentanil
#17
Sung Kwan Choi, Myung Ha Yoon, Jung Il Choi, Woong Mo Kim, Bong Ha Heo, Keun Seok Park, Ji A Song
BACKGROUND: Although intraoperative opioids provide more comfortable anesthesia and reduce the use of postoperative analgesics, it may cause opioid induced hyperalgesia (OIH). OIH is an increased pain response to opioids and it may be associated with N-methyl-D-aspartate (NMDA) receptor. This study aimed to determine whether intraoperative nefopam or ketamine, known being related on NMDA receptor, affects postoperative pain and OIH after continuous infusion of intraoperative remifentanil...
October 2016: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/27693070/is-there-a-role-for-intravenous-subdissociative-dose-ketamine-administered-as-an-adjunct-to-opioids-or-as-a-single-agent-for-acute%C3%A2-pain-management-in-the-emergency-department
#18
Sergey Motov, Steven Rosenbaum, Gary M Vilke, Yuko Nakajima
BACKGROUND: Whether acute or chronic, emergency physicians frequently encounter patients reporting pain. It is the responsibility of the emergency physician to assess and evaluate, and if appropriate, safely and effectively reduce pain. Recently, analgesics other than opioids are being considered in an effort to provide safe alternatives for pain management in the emergency department (ED). Opioids have significant adverse effects such as respiratory depression, hypotension, and sedation, to say nothing of their potential for abuse...
December 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27676665/efficacy-and-safety-of-ketamine-added-to-local-anesthetic-in-modified-pectoral-block-for-management-of-postoperative-pain-in-patients-undergoing-modified-radical-mastectomy
#19
Ahmed H Othman, Ahmad M Abd El-Rahman, Fatma El Sherif
BACKGROUND: Breast surgery is an exceedingly common procedure with an increased incidence of acute and chronic pain. Pectoral nerve block is a novel peripheral nerve block alternative to neuro-axial and paravertebral blocks for ambulatory breast surgeries. OBJECTIVES: This study aims to compare the analgesic efficacy and safety of modified Pecs block with ketamine plus bupivacaine versus bupivacaine in patients undergoing breast cancer surgery. STUDY DESIGN: A randomized, double-blind, prospective study...
September 2016: Pain Physician
https://www.readbyqxmd.com/read/27625488/factors-affecting-recovery-of-postoperative-bowel-function-after-pediatric-laparoscopic-surgery
#20
Daphnée Michelet, Juliette Andreu-Gallien, Alia Skhiri, Arnaud Bonnard, Yves Nivoche, Souhayl Dahmani
BACKGROUND AND AIMS: Laparoscopic pediatric surgery allows a rapid postoperative rehabilitation and hospital discharge. However, the optimal postoperative pain management preserving advantages of this surgical technique remains to be determined. This study aimed to identify factors affecting the postoperative recovery of bowel function after laparoscopic surgery in children. MATERIAL AND METHODS: A retrospective analysis of factors affecting recovery of bowel function in children and infants undergoing laparoscopic surgery between January 1, 2009 and September 30, 2009, was performed...
July 2016: Journal of Anaesthesiology, Clinical Pharmacology
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