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Ketamine and morphine

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https://www.readbyqxmd.com/read/28707454/interventions-for-postoperative-pain-in-children-an-overview-of-systematic-reviews
#1
REVIEW
Krste Boric, Svjetlana Dosenovic, Antonia Jelicic Kadic, Marijan Batinic, Marija Cavar, Marjan Urlic, Nikolina Markovina, Livia Puljak
The aim of this study was to conduct an overview of systematic reviews that summarizes the results about efficacy and safety from randomized controlled trials involving the various strategies used for postoperative pain management in children. We searched the Cochrane Database of Systematic Reviews, CINAHL, Database of Reviews of Effect, Embase, MEDLINE, and PsycINFO from the earliest date to January 24, 2016. This overview included 45 systematic reviews that evaluated interventions for postoperative pain in children...
July 14, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28700455/perioperative-ketamine-for-analgesia-in-spine-surgery-a-meta-analysis-of-randomized-controlled-trials
#2
Arif Pendi, Ryan Field, Saifal-Deen Farhan, Martin Eichler, Stacey Samuel Bederman
STUDY DESIGN: Meta-analysis of randomized controlled trials. OBJECTIVE: To evaluate the effectiveness of perioperative supplemental ketamine to reduce postoperative opioid analgesic consumption following spine surgery. SUMMARY OF BACKGROUND DATA: Although low-dose supplemental ketamine has been known to reduce pain after surgery, there is conflicting evidence regarding whether ketamine can be effective to reduce opioid consumption following spine surgery...
July 11, 2017: Spine
https://www.readbyqxmd.com/read/28687197/opioid-receptor-activation-is-involved-in-neuroprotection-induced-by-trpv1-channel-activation-against-excitotoxicity-in-the-rat-retina
#3
Kenji Sakamoto, Taiyo Kuroki, Tomonori Sagawa, Hiroko Ito, Asami Mori, Tsutomu Nakahara, Kunio Ishii
Recently, we reported that capsaicin, a transient receptor potential vanilloid type1 (TRPV1) agonist, protected against excitotoxicity induced by intravitreal N-methyl-D-aspartic acid (NMDA) in the rats in vivo. It has been reported that morphine, an opioid receptor agonist, ameliorated excitotoxicity induced by ischemia-reperfusion in the retina, and that capsaicin-induced neuroprotection was reduced by naloxone, an opioid receptor antagonist in the brain. The aim of the present study is to clarify whether activation of opioid receptors is involved in the capsaicin-induced neuroprotection in the retina...
July 4, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28686986/illicit-drug-consumption-in-school-populations-measured-by-wastewater-analysis
#4
Ettore Zuccato, Emma Gracia-Lor, Nikolaos I Rousis, Alberto Parabiaghi, Ivan Senta, Francesco Riva, Sara Castiglioni
BACKGROUND: Analysis of student consumption of illicit drugs (ID) by school population surveys (SPS) provides information useful for prevention, but the results may be influenced by subjective factors. We explored wastewater (WW) analysis to improve the information. METHODS: We used WW analysis to measure ID consumption in eight secondary schools in Italy in 2010-13 (students aged 15-19). Samples were collected from the sewage pipes of the schools during lessons for one week each year...
June 24, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28682950/baseline-morphine-consumption-may-explain-between-study-heterogeneity-in-meta-analyses-of-adjuvant-analgesics-and-improve-precision-and-accuracy-of-effect-estimates
#5
Brett Doleman, Alex J Sutton, Matthew Sherwin, Jonathan N Lund, John P Williams
BACKGROUND: Statistical heterogeneity can increase the uncertainty of results and reduce the quality of evidence derived from systematic reviews. At present, it is uncertain what the major factors are that account for heterogeneity in meta-analyses of analgesic adjuncts. Therefore, the aim of this review was to identify whether various covariates could explain statistical heterogeneity and use this to improve accuracy when reporting the efficacy of analgesics. METHODS: We searched for reviews using MEDLINE, EMBASE, CINAHL, AMED, and the Cochrane Database of Systematic Reviews...
July 4, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28673215/the-effect-of-a-perioperative-ketamine-infusion-on-the-incidence-of-chronic-postsurgical-pain-a-pilot-study
#6
P J Peyton, C Wu, T Jacobson, M Hogg, F Zia, K Leslie
Chronic postsurgical pain (CPSP) is a common and debilitating complication of major surgery. We undertook a pilot study at three hospitals to assess the feasibility of a proposed large multicentre placebo-controlled randomised trial of intravenous perioperative ketamine to reduce the incidence of CPSP. Ketamine, 0.5 mg/kg pre-incision, 0.25 mg/kg/hour intraoperatively and 0.1 mg/kg/hour for 24 hours, or placebo, was administered to 80 patients, recruited over a 15-month period, undergoing abdominal or thoracic surgery under general anaesthesia...
July 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28657160/ketamine-as-an-adjuvant-to-opioids-for-cancer-pain
#7
REVIEW
Rae F Bell, Christopher Eccleston, Eija A Kalso
BACKGROUND: This is an update of a review first published in 2003 and updated in 2012.Ketamine is a commonly used anaesthetic agent, and in subanaesthetic doses is also given as an adjuvant to opioids for the treatment of refractory cancer pain, when opioids alone or in combination with appropriate adjuvant analgesics prove to be ineffective. Ketamine is known to have psychomimetic (including hallucinogenic), urological, and hepatic adverse effects. OBJECTIVES: To determine the effectiveness and adverse effects of ketamine as an adjuvant to opioids for refractory cancer pain in adults...
June 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28625307/postcesarean-delivery-analgesia
#8
REVIEW
Brendan Carvalho, Alexander J Butwick
Effective pain management should be a key priority in women undergoing cesarean delivery. Suboptimal perioperative pain management is associated with chronic pain, greater opioid use, delayed functional recovery, impaired maternal-fetal bonding, and increased postpartum depression. Severe acute postoperative pain is also strongly associated with persistent pain after cesarean delivery. Multimodal analgesia is the core principle for cesarean delivery pain management. The use of neuraxial morphine and opioid-sparing adjuncts such as scheduled nonsteroidal anti-inflammatory medications and acetaminophen is recommended for all women undergoing cesarean delivery with neuraxial anesthesia unless contraindicated...
March 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/28609318/biochemical-and-pharmacological-characterization-of-a-mice-model-of-complex-regional-pain-syndrome
#9
Vaskar Das, Jeffrey S Kroin, Mario Moric, Asokumar Buvanendran
BACKGROUND AND OBJECTIVES: Complex regional pain syndrome is a challenging disease to treat. Recently, a mouse fracture model of complex regional pain syndrome has been developed that has many signs of the clinical syndrome. However, many aspects of the sensory neuron biochemistry and behavioral and pharmacological characterization of this model remain to be clarified. METHODS: Mice were randomly assigned to fracture/cast or control (naive) groups. Fracture/cast mice underwent a closed distal tibia facture, with hindlimb wrapped in casting tape for 3 weeks...
July 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28601204/battlefield-analgesia-in-tactical-combat-casualty-care
#10
REVIEW
Ian S Wedmore, Frank K Butler
At the start of the Afghanistan conflict, battlefield analgesia for US military casualties was achieved primarily through the use of intramuscular (IM) morphine. This is a suboptimal choice, since IM morphine is slow-acting, leading to delays in effective pain relief and the risk of overdose and death when dosing is repeated in order to hasten the onset of analgesia. Advances in battlefield analgesia, pioneered initially by Tactical Combat Casualty Care (TCCC), and the Army's 75th Ranger Regiment, have now been incorporated into the Triple-Option Analgesia approach...
June 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28591084/efficacy-of-postoperative-analgesia-of-local-ketamine-wound-instillation-following-total-thyroidectomy-a-randomized-double-blind-controlled-clinical-trial
#11
Ahmad M Abd El-Rahman, Fatma A El Sherif
BACKGROUND: Total thyroidectomy is recommended as a line of management of thyroid cancer in a lot of cases. Our aim was to compare postoperative analgesic effect of local ketamine 1 mg/kg instilled in the wound to I.M ketamine and to placebo after total thyroidectomy. METHODS: Ninety patients aged 18 - 60 years, American Society of Anesthesiologists (ASA) class I-II, with a body weight of 50-90 kg, scheduled for total thyroidectomy were enrolled after ethics committee approval in this prospective, randomized, double-blind, controlled study and divided randomly into three groups to receive after hemostasis: Group (I): 1 mg/kg ketamine in a total volume of 10 mL normal saline instilled in the wound...
June 6, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28520955/effect-of-intrathecally-administered-ketamine-morphine-and-their-combination-added-to-bupivacaine-in-patients-undergoing-major-abdominal-cancer-surgery-a-randomized-double-blind-study
#12
Ahmad M Abd El-Rahman, Ashraf A Mohamed, Sahar A Mohamed, Mohamed A M Mostafa
Objective. : Effective postoperative pain control reduces postoperative morbidity. In this study, we investigated the effects of intrathecal morphine, ketamine, and their combination with bupivacaine for postoperative analgesia in major abdominal cancer surgery. Study Design. : Prospective, randomized, double-blind. Setting. : Academic medical center. Patients and Methods.:  Ninety ASA I-III patients age 30 to 50 years were divided randomly into three groups: the morphine group (group M) received 10 mg of hyperbaric bupivacaine 0...
May 17, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28511482/effect-of-ketofol-on-pain-and-complication-after-caesarean-delivery-under-spinal-anaesthesia-a-randomized-double-blind-clinical-trial
#13
Molouk Jaafarpour, Aminolah Vasigh, Javaher Khajavikhan, Ali Khani
INTRODUCTION: Pain is the key concern of women after caesarean delivery that may interfere with breastfeeding. AIM: The aim of this study was to assess effect of ketofol (ketamine/propofol combination) on pain and complication after caesarean delivery under spinal anaesthesia. MATERIALS AND METHODS: In this randomized double-blind clinical trial, 92 parturient scheduled for elective caesarean delivery under spinal anaesthesia were included...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28468568/impact-of-low-dose-ketamine-on-the-usage-of-continuous-opioid-infusion-for-the-treatment-of-pain-in-adult-mechanically-ventilated-patients-in-surgical-intensive-care-units
#14
Jessica L Buchheit, Daniel Dante Yeh, Matthias Eikermann, Hsin Lin
BACKGROUND: Ketamine at subanesthetic doses has been shown to provide analgesic effects without causing respiratory depression and may be a viable option in mechanically ventilated patients to assist with extubation. The aim of this study was to evaluate the effects of low-dose ketamine on opioid consumption in mechanically ventilated adult surgical intensive care unit (ICU) patients. METHODS: A retrospective review of mechanically ventilated adult patients receiving low-dose ketamine continuous infusion (1-5 µcg/kg/min) for adjunctive pain control admitted to surgical ICUs was conducted...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28463863/is-subdissociative-ketamine-as-safe-and-effective-as-morphine-for-pain-management-in-the-emergency-department
#15
Patricia Kunz Howard, Christine M Gisness
: Review of recent evidence with translation to practice for the advanced practice nurse (APN) role is presented using a case study module for "Intravenous Subdissociative-Dose Ketamine Versus Morphine for Analgesia in the Emergency Department: A Randomized Controlled Trial." This prospective, randomized controlled inquiry enrolled 90 patients into 2 groups (ketamine vs. morphine) for patients seeking care in an emergency department with acute pain. Data regarding pain scores were collected at baseline, 15, 30, 60, 90, and 120 min...
April 2017: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/28442956/a-comparison-between-intravenous-lidocaine-and-ketamine-on-acute-and-chronic-pain-after-open-nephrectomy-a-prospective-double-blind-randomized-placebo-controlled-study
#16
Ali Jendoubi, Imed Ben Naceur, Abderrazak Bouzouita, Mehdi Trifa, Salma Ghedira, Mohamed Chebil, Mohamed Houissa
BACKGROUND: Recently, there has been increasing interest in the use of analgesic adjuncts such as intravenous (IV) ketamine and lidocaine. OBJECTIVES: To compare the effects of perioperative IV lidocaine and ketamine on morphine requirements, pain scores, quality of recovery, and chronic pain after open nephrectomy. STUDY DESIGN: A prospective, randomized, placebo-controlled, double-blind trial. SETTINGS: The study was conducted in Charles Nicolle University Hospital of Tunis...
April 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28435316/subanesthetic-ketamine-for-pain-management-in-hospitalized-children-adolescents-and-young-adults-a-single-center-cohort-study
#17
Kathy A Sheehy, Caroline Lippold, Amy L Rice, Raissa Nobrega, Julia C Finkel, Zenaide Mn Quezado
BACKGROUND: Subanesthetic doses of ketamine, an N-methyl-d-aspartate receptor antagonist used as an adjuvant to opioid for the treatment of pain in adults with acute and chronic pain, have been shown, in some instances, to improve pain intensity and to decrease opioid intake. However, less is known about the role of ketamine in pain management in children, adolescents, and young adults. PURPOSE: We examined the effects of subanesthetic ketamine on pain intensity and opioid intake in children, adolescents, and young adults with acute and chronic pain syndromes treated in an inpatient setting...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28422864/ketamine-as-adjuvant-analgesics-for-patients-with-refractory-cancer-pain-does-affect-il-2-ifn-%C3%AE-expression-of-t-cells-in-vitro-a-prospective-randomized-double-blind-study
#18
RANDOMIZED CONTROLLED TRIAL
Naibao Zhou, Zhijian Fu, Hao Li, Kaiguo Wang
BACKGROUND: Ketamine has been used as an analgesic adjuvant with morphine in the treatment of refractory cancer pain recently. But both morphine and ketamine have been reported to produce a number of immunomodulatory effects. The current study was performed to assess whether the concentration of ketamine, as adjuvant analgesics for patient with refractory cancer pain, was related to its effect on T cells interleukin-2 (IL-2)/interferon-γ (IFN-γ) expression in vitro. METHODS: Peripheral blood mononuclear cells (PBMCs) were isolated from venous blood of patients with refractory cancer pain over a Ficoll-Hypaque density gradient...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28412576/the-occurrence-of-alcohol-drugs-by-toxicological-examination-of-selected-drivers-in-hong-kong
#19
Wing-Chi Cheng, Kwok-Leung Dao
The study is to investigate the extent of alcohol/drug(s) use among selected drivers, i.e. fatally injured drivers from traffic accidents (2006-2015), drink driving (2006-2015) and drug driving (2010-2015) cases, in Hong Kong. Between 2006 and 2015, specimens from a total of 223 fatally injured drivers were received for toxicological examination. Except for one driver, all other drivers with positive findings were male. Alcohol and/or drugs were detected in 60 (27%) cases where alcohol alone was detected in 40 cases (18%) while drugs with/without alcohol were detected in 20 cases (9%)...
June 2017: Forensic Science International
https://www.readbyqxmd.com/read/28405033/post-caesarean-analgesia-what-is-new
#20
REVIEW
Sukhyanti Kerai, Kirti Nath Saxena, Bharti Taneja
Adequate post-operative analgesia after caesarean section (CS) is vital as it impacts the distinct surgical recovery requirements of the parturient. Although newer analgesic modalities and drugs for post-caesarean analgesia have been introduced over the recent years, review of the literature suggests suggests that we are far from achieving the goals of optimum post-operative analgesia. We conducted a systematic review of recent advances in modalities for post-caesarean analgesia. After systematic search and quality assessment of studies, we included a total of 51 randomised controlled trials that evaluated the role of opioids, transversus abdominis plane (TAP) block, wound infiltration/infusion, ketamine, gabapentin and ilioinguinal-iliohypogastric nerve block (II-IH NB) for post-caesarean analgesia...
March 2017: Indian Journal of Anaesthesia
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