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Ketamine and morphine

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https://www.readbyqxmd.com/read/27864394/bet-2-low-dose-ketamine-for-acute-pain-in-the-ed
#1
Colby Duncan, Brad Riley
A short cut review was carried out to establish whether low-dose ketamine is better than morphine at safely and effectively reducing pain scores in ED patients with acute pain who do not respond to conventional therapies. One hundred and thirty-two papers were found using the reported searches, of these three presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated...
December 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27829367/intranasal-ketamine-for-acute-traumatic-pain-in-the-emergency-department-a-prospective-randomized-clinical-trial-of-efficacy-and-safety
#2
Shachar Shimonovich, Roy Gigi, Amir Shapira, Tal Sarig-Meth, Danielle Nadav, Mattan Rozenek, Debra West, Pinchas Halpern
BACKGROUND: Ketamine has been well studied for its efficacy as an analgesic agent. However, intranasal (IN) administration of ketamine has only recently been studied in the emergency setting. The objective of this study was to elucidate the efficacy and adverse effects of a sub-dissociative dose of IN Ketamine compared to IV and IM morphine. METHODS: A single-center, randomized, prospective, parallel clinical trial of efficacy and safety of IN ketamine compared to IV and IM morphine for analgesia in the emergency department (ED)...
November 9, 2016: BMC Emergency Medicine
https://www.readbyqxmd.com/read/27829018/paravertebral-block-plus-thoracic-wall-block-versus-paravertebral-block-alone-for-analgesia-of-modified-radical-mastectomy-a-retrospective-cohort-study
#3
Nai-Liang Li, Ben-Long Yu, Chen-Fang Hung
BACKGROUND AND OBJECTIVES: Paravertebral block placement was the main anesthetic technique for modified radical mastectomy in our hospital until February 2014, when its combination with blocks targeting the pectoral musculature was initiated. We compared the analgesic effects of paravertebral blocks with or without blocks targeting the pectoral musculature for modified radical mastectomy. METHODS: We retrospectively collected data from a single surgeon and anesthesiologist from June 1, 2012, to May 31, 2015...
2016: PloS One
https://www.readbyqxmd.com/read/27780181/benefit-and-harm-of-adding-ketamine-to-an-opioid-in-a-patient-controlled-analgesia-device-for-the-control-of-postoperative-pain-systematic-review-and-meta-analyses-of-randomized-controlled-trials-with-trial-sequential-analyses
#4
Benjamin Assouline, Martin R Tramèr, Lukas Kreienbühl, Nadia Elia
Ketamine is often added to opioids in patient-controlled analgesia devices. We tested whether in surgical patients, ketamine added to an opioid patient-controlled analgesia decreased pain intensity by ≥25%, cumulative opioid consumption by ≥30%, the risk of postoperative nausea and vomiting by ≥30%, the risk of respiratory adverse effects by ≥50%, and increased the risk of hallucination not more than 2-fold. In addition, we searched for evidence of dose-responsiveness. Nineteen randomized trials (1349 adults, 104 children) testing different ketamine regimens added to various opioids were identified through searches in databases and bibliographies (to 04...
August 29, 2016: Pain
https://www.readbyqxmd.com/read/27748174/positive-neonatal-urine-comprehensive-drug-screen-low-birth-weight-and-withdrawal-symptoms-in-a-neonatal-unit-a-case-control-study
#5
Kam Lun Hon, Michael Ho Ming Chan, Ming Him James Ng, Chi Cheung Ho, Yin Ching Kathy Tsang, Wing Hung Tam, Chung Shun Ho
OBJECTIVE: Maternal drug abuse may influence neonatal outcomes. We compared neonatal outcomes of patients with urine screened positive for commonly abused drugs (CAD) versus those who were screened negative, and reviewed the pattern of drugs detected at a university teaching hospital. METHODS: Urine samples collected from babies with suspected illicit drug exposure who were admitted to the neonatal unit were sent for comprehensive drug screen (CDS) performed by liquid chromatography-time-of-flight mass spectrometry (LC-TOF/MS)...
October 10, 2016: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/27737513/pharmacologic-interventions-for-treating-phantom-limb-pain
#6
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/27703954/multimodal-analgesia-with-ketamine-or-tramadol-in-combination-with-intravenous-paracetamol-after-renal-surgery
#7
Mohammad Reza Khajavi, Seyed Mehdi Sabouri, Reza Shariat Moharari, Pejman Pourfakhr, Atabak Najafi, Farhad Etezadi, Farsad Imani
BACKGROUND: Opioids are generally the preferred analgesic agents during the early postoperative period. OBJECTIVES: The present study was designed to assess and compare the multimodal analgesic effects of ketamine and tramadol in combination with intravenous acetaminophen after renal surgery. PATIENTS AND METHODS: This randomized, double-blinded, clinical trial was conducted on 80 consecutive patients undergoing various types of kidney surgeries in Sina hospital in Tehran in 2014 - 2016...
July 2016: Nephro-urology Monthly
https://www.readbyqxmd.com/read/27703629/comparison-of-effects-of-intraoperative-nefopam-and-ketamine-infusion-on-managing-postoperative-pain-after-laparoscopic-cholecystectomy-administered-remifentanil
#8
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/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
#9
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/27635743/the-effect-of-low-dose-ketamine-via-patient-controlled-analgesic-pump-on-morphine-consumption-in-the-postoperative-period-in-thoracotomies-a-systematic-review-protocol
#10
Saul Martinez, Sherrin Alexander
The objective of this systematic review is to determine if adding low-dose ketamine to a morphine patient-controlled analgesic pump will have an impact on the total consumption of morphine during the first 72 hours postoperative in patients over the age of 15 undergoing surgery involving thoracotomy. In addition, secondary outcomes assessing the impact on pain, nausea and vomiting will be evaluated for any alteration with ketamine co-administration.
August 2016: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/27625488/factors-affecting-recovery-of-postoperative-bowel-function-after-pediatric-laparoscopic-surgery
#11
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
https://www.readbyqxmd.com/read/27609854/study-protocol-of-a-randomised-controlled-trial-of-intranasal-ketamine-compared-with-intranasal-fentanyl-for-analgesia-in-children-with-suspected-isolated-extremity-fractures-in-the-paediatric-emergency-department
#12
Stacy L Reynolds, Jonathan R Studnek, Kathleen Bryant, Kelly VanderHave, Eric Grossman, Charity G Moore, James Young, Melanie Hogg, Michael S Runyon
INTRODUCTION: Fentanyl is the most widely studied intranasal (IN) analgesic in children. IN subdissociative (INSD) ketamine may offer a safe and efficacious alternative to IN fentanyl and may decrease overall opioid use during the emergency department (ED) stay. This study examines the feasibility of a larger, multicentre clinical trial comparing the safety and efficacy of INSD ketamine to IN fentanyl and the potential role for INSD ketamine in reducing total opioid medication usage. METHODS AND ANALYSIS: This double-blind, randomised controlled, pilot trial will compare INSD ketamine (1 mg/kg) to IN fentanyl (1...
September 8, 2016: BMJ Open
https://www.readbyqxmd.com/read/27606558/sedation-and-analgesia-for-dressing-change-a-survey-of-american-burn-association-burn-centers
#13
Rachel Myers, Jeanette Lozenski, Matthew Wyatt, Maria Peña, Kayla Northrop, Dhaval Bhavsar, Anthony Kovac
Pain and sedation management for patients undergoing burn dressing change can be challenging. Variations appear to exist in the selection of medications before and during burn dressing change. To determine if institutional variations exist in pain and sedation management for burn dressing change, an online survey was sent to ABA Burn Center nurses and physicians. Three hundred seventy-eight anonymous responses were received from nurses (72%), nurse practitioners (10%), and physicians (18%). Burn centers had adult (22%), pediatric (12%), or pediatric and adult (66%) patients...
August 18, 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/27474362/identification-of-drugs-in-parenteral-pharmaceutical-preparations-from-a-quality-assurance-and-a-diversion-program-by-direct-analysis-in-real-time-accutoftm-mass-spectrometry-dart-ms
#14
Justin L Poklis, Amanda J Mohs, Carl E Wolf, Alphonse Poklis, Michelle R Peace
In healthcare settings drug diversion and impairment of physicians are major concerns requiring a rapid and efficient method for surveillance and detection. A Direct Analysis in Real Time ion source coupled to a JEOL AccuTOF(TM) time-of-flight mass spectrometer (DART-MS) method was developed to screen parenteral pharmaceutical formulations for potential drug diversion. Parenteral pharmaceutical formulations are also known as injectable formulations and are used with intravenous, subcutaneous, intramuscular and intra-articular administration...
October 2016: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/27454273/intrathecal-dexmedetomidine-ketamine-and-their-combination-added-to-bupivacaine-for-postoperative-analgesia-in-major-abdominal-cancer-surgery
#15
Sahar Abd-Elbaky Mohamed, Ahmad Mohammad Abd El-Rahman, Khaled M Fares
BACKGROUND: Intrathecal ketamine has been studied extensively in animals, but rarely in humans. Intrathecal dexmedetomidine prolongs the duration of spinal anesthesia. OBJECTIVE: To investigate the efficacy and safety of intrathecal dexmedetomidine, ketamine, or both when added to bupivacaine for postoperative analgesia in major abdominal cancer surgery. DESIGN: Double-blinded, randomized, controlled trial. SETTING: Academic medical center...
July 2016: Pain Physician
https://www.readbyqxmd.com/read/27398889/prolonged-perioperative-low-dose-ketamine-does-not-improve-short-and-long-term-outcomes-after-pediatric-idiopathic-scoliosis-surgery
#16
Marina Perelló, David Artés, Cristina Pascuets, Elisabeth Esteban, Ana Maria Ey
STUDY DESIGN: Randomized, double-blind, placebo-controlled study, with a six-month follow-up period. OBJECTIVES: To test the hypothesis that a 72-hour dose of subanesthetic ketamine in this surgical procedure reduces postoperative morphine use; To assess if there are fewer adverse effects, if postoperative recovery is faster, if there is less peri-incisional hyperalgesia or if there is lower incidence of persistent postsurgical pain. SUMMARY OF BACKGROUND DATA: Tissue injury and high opioid requirements following posterior spinal fusion surgery produce central sensitization, which can in turn be associated with hyperalgesia and chronic pain...
July 7, 2016: Spine
https://www.readbyqxmd.com/read/27388793/adjunct-analgesic-drugs-to-local-anaesthetics-for-neuroaxial-blocks-in-children
#17
Märit Lundblad, Per-Arne Lönnqvist
PURPOSE OF REVIEW: This article reviews various adjunct drugs used in the context of neuroaxial blocks in children and to provide a literature and evidence-based suggestion for the rational use of such adjuncts. RECENT FINDINGS: Contrary to plain local anaesthetics, preservative-free morphine and clonidine, ketamine in neonatal rodents has been found to enhance apoptosis in the spinal cord. Dexmedetomidine has been shown to be equally effective as clonidine as an adjunct to caudal blocks...
October 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27381058/drug-use-and-its-associated-factors-among-money-boys-in-hunan-province-china
#18
G L Yang, A D Zhang, Y Yu, H Liu, F Y Long, J Yan
OBJECTIVES: To describe drug use, types of drugs and related factors among money boys in Hunan Province, China. STUDY DESIGN: A cross-sectional study was conducted between July 2012 and January 2013. METHODS: Based on respondent-driven sampling, researchers located seven 'seeds' via a gay-dating website: http://www.ixxqy.org. After three waves of recruitment, 234 money boys were enrolled. They were asked to complete a 23-item questionnaire regarding demographic characteristics, drug use, a history of human immunodeficiency virus infection and family environment...
November 2016: Public Health
https://www.readbyqxmd.com/read/27363637/morphine-and-ketamine-inhibit-immune-function-of-gastric-cancer-patients-by-increasing-percentage-of-cd4-cd25-foxp3-regulatory-t%C3%A2-cells-in%C3%A2-vitro
#19
Min Hou, Nai-Bao Zhou, Hao Li, Bao-Sheng Wang, Xiu-Qin Wang, Xing-Wu Wang, Kai-Guo Wang, Fu-Shan Xue
BACKGROUND: There is conflicting evidence regarding effects of anesthetic and analgesic drugs on immune function of cancer patients. This study was designed to observe changes of T cell subpopulations in the gastric cancer (GC) patients and to assess effects of morphine and ketamine on the CD4(+) T cells, CD8(+) T cells, and regulatory T cells (Tregs) populations obtained from the GC patients in vitro. METHODS: The peripheral blood samples from 20 GC patients and 20 healthy volunteers were obtained...
June 15, 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27331368/time-to-analgesia-in-an-emergency-department-in-eastern-nepal
#20
Rabin Bhandari, Gyanendra Malla, Bijendra Kumar Rai, Chris Curry
OBJECTIVES: Nepal is a least developed country, with limited healthcare resources. An 18 month Fellowship in Emergency Medicine has contributed some improvements to care. This study assessed time to first analgesia in higher and lower acuity patients. METHODS: A prospective observational study of 101 patients in each of the Australasian Triage Scale (ATS) 2, 3 and 100 in ATS 4 was undertaken at B.P. Koirala Institute of Health Sciences. Convenience sampling was used coinciding with researcher's duty hours...
August 2016: Emergency Medicine Australasia: EMA
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