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Ketamine and morphine

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https://www.readbyqxmd.com/read/28282236/comparison-of-morphine-morphine-lidocaine-and-morphine-lidocaine-ketamine-infusions-in-dogs-using-an-incision-induced-pain-model
#1
Ludovica Chiavaccini, Andrew K Claude, Robert E Meyer
We aimed to compare antinociceptive effects of IV infusions of morphine (M), morphine-lidocaine (ML), or morphine-lidocaine-ketamine (MLK) combined, in a mild-to-moderate pain model in dogs. Eighteen adult hounds were heavily sedated with IV morphine (0.2 mg/kg) and dexmedetomidine to undergo thoracic skin incisions. After reversal, dogs were randomly assigned to receive loading doses of lidocaine and ketamine (MLK), lidocaine and saline (ML), or equivalent volume of saline (M), followed by 18 hr constant infusions of morphine (0...
March 2017: Journal of the American Animal Hospital Association
https://www.readbyqxmd.com/read/28279542/the-use-of-ketamine-for-acute-treatment-of-pain-a-randomized-double-blind-placebo-controlled-trial
#2
Billy Sin, Tamara Tatunchak, Mohammad Paryavi, Maria Olivo, Usman Mian, Josel Ruiz, Bupendra Shah, Sylvie de Souza
BACKGROUND: Pain is one of the most common reasons for emergency department (ED) visits in the United States. Ketamine is a sedative with N-methyl-D-aspartate (NMDA) receptor antagonism. Recent literature has suggested that the use of subdissociative dose ketamine (SDDK) may be safe and effective for acute pain. OBJECTIVE: The objective of our study was to evaluate ketamine in subdissociative doses as an adjunct for acute pain in the ED. METHODS: This was a single-center, prospective, randomized, double-blind, placebo-controlled trial that evaluated the use of SDDK in adult patients who presented to the ED with acute pain...
March 6, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28067693/intraoperative-ketamine-reduces-immediate-postoperative-opioid-consumption-after-spinal-fusion-surgery-in-chronic-pain-patients-with-opioid-dependency-a-randomized-blinded-trial
#3
Rikke Vibeke Nielsen, Jonna Storm Fomsgaard, Hanna Siegel, Robertas Martusevicius, Lone Nikolajsen, Jørgen Berg Dahl, Ole Mathiesen
Perioperative handling of surgical patients with opioid dependency represents an important clinical problem. Animal studies suggest that ketamine attenuates central sensitization and hyperalgesia and thereby reduces postoperative opioid tolerance. We hypothesized that intraoperative ketamine would reduce immediate postoperative opioid consumption compared with placebo in chronic pain patients with opioid dependency undergoing lumbar spinal fusion surgery. Primary outcome was morphine consumption 0 to 24 hours postoperatively...
March 2017: Pain
https://www.readbyqxmd.com/read/28059998/effect-of-subchronic-exposure-to-opioids-on-the-effective-dose-of-intravenous-and-inhalation-anaesthetics
#4
Mengchan Ou, Yu Li, Yi Kang, Xiaolin Zhao, Tao Zhu
This study aimed to investigate the effect of subchronic exposure to morphine on the 50% effective dose (EC50) (median effective concentration/EC50) values of intravenous (propofol and ketamine) and inhalation (sevoflurane) anaesthetics in mice. Eight to 12-week-old male mice were administered morphine subcutaneously for 5 days to create a subchronic morphine exposure model. Control mice were injected with saline. The EC50 for righting reflex loss and tail clip reflex of general anaesthetics on the first (D1), third (D3) and seventh days (D7), after establishing a subchronic morphine exposure model, were determined...
January 2, 2017: Behavioural Pharmacology
https://www.readbyqxmd.com/read/28006946/a-novel-experimental-model-of-acute-respiratory-distress-syndrome-in-pig
#5
M Otáhal, M Mlček, I Vítková, O Kittnar
Acute respiratory distress syndrome (ARDS) is severe medical condition occurring in critically ill patients and with mortality of 33-52 % is one of the leading causes of death in critically ill patients. To better understand pathophysiology of ARDS and to verify novel therapeutical approaches a reliable animal model is needed. Therefore we have developed modified lavage model of ARDS in the pig. After premedication (ketamine and midazolam) 35 healthy pigs were anesthetized (propofol, midazolam, morphin, pipecuronium) and orotracheally intubated and ventilated...
December 22, 2016: Physiological Research
https://www.readbyqxmd.com/read/27931762/comparison-of-intranasal-ketamine-versus-intravenous-morphine-in-reducing-pain-in-patients-with-renal-colic
#6
Mohammad Reza Farnia, Alireza Jalali, Elnaz Vahidi, Mehdi Momeni, Javad Seyedhosseini, Morteza Saeedi
BACKGROUND: Various drugs have been used to relieve abdominal pain in patients with renal colic. Ketamine is a popular choice as an analgesic. OBJECTIVE: To compare the effectiveness of intranasal (IN) ketamine versus intravenous (IV) morphine in reducing pain in patients with renal colic. METHODS: A randomized double-blind controlled trial was performed in 53 patients with renal colic recruited from the emergency department (ED) in 2015. Finally, 40 patients were enrolled in this study...
November 22, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27919589/preincisional-and-postoperative-epidural-morphine-ropivacaine-ketamine-and-naloxone-treatment-for-postoperative-pain-management-in-upper-abdominal-surgery
#7
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/27864394/bet-2-low-dose-ketamine-for-acute-pain-in-the-ed
#8
REVIEW
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
#9
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
#10
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
#11
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/urine-comprehensive-drug-screen-low-birth-weight-and-withdrawal-symptoms-in-a-neonatal-unit-a-case-control-study
#12
Kam L Hon, Michael H M Chan, Ming H J Ng, Chi C Ho, Kathy Y C Tsang, Wing H Tam, Chung S 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 chromatographytime- of-flight mass spectrometry (LC-TOF/MS)...
2016: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/27737513/pharmacologic-interventions-for-treating-phantom-limb-pain
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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...
January 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
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