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Ketamine for pain

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https://www.readbyqxmd.com/read/29775117/intravenous-low-dose-ketamine-provides-greater-pain-control-compared-to-fentanyl-in-a-civilian-prehospital-trauma-system-a-propensity-matched-analysis
#1
E Stein Bronsky, Catherine Koola, Alessandro Orlando, Diane Redmond, Cecile D'Huyvetter, Heather Sieracki, Allen Tanner, Ray Fowler, Charles Mains, David Bar-Or
OBJECTIVE: A few studies report comparable analgesic efficacy between low-dose ketamine and opioids such as morphine or fentanyl; however, limited research has explored the safety and effectiveness of intravenous low-dose ketamine as a primary analgesic in a civilian prehospital setting. The objective of this study is to compare pain control between low-dose ketamine and fentanyl when administered intravenously (IV) for the indication of severe pain. METHODS: This was a retrospective, observational review of prehospital adult patients (≥18 years) who presented with severe pain (numeric rating scale, 7-10) and were treated solely with either low-dose ketamine IV or fentanyl IV between January 1, 2014 and December 31, 2016...
May 18, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29773953/mir-34a-mediated-regulation-of-xist-in-female-cells-under-inflammation
#2
Botros B Shenoda, Yuzhen Tian, Guillermo M Alexander, Enrique Aradillas-Lopez, Robert J Schwartzman, Seena K Ajit
Background: Evidence is overwhelming for sex differences in pain, with women representing the majority of the chronic pain patient population. There is a need to explore novel avenues to elucidate this sex bias in the development of chronic inflammatory pain conditions. Complex regional pain syndrome (CRPS) is a chronic neuropathic pain disorder, and the incidence of CRPS is greater in women than in men by ~4:1. Since neurogenic inflammation is a key feature of CRPS, dysregulation of inflammatory responses can be a factor in predisposing women to chronic pain...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29771804/preemptive-analgesia-decreases-pain-following-anorectal-surgery-a-prospective-randomized-double-blinded-placebo-controlled-trial
#3
Justin T Van Backer, Matthew R Jordan, Danielle T Leahy, Jesse S Moore, Peter Callas, Timothy Dominick, Peter A Cataldo
BACKGROUND: Postoperative pain is a frequent cause for delayed discharge following outpatient procedures, including anorectal surgery. Both central and peripheral pain receptor sensitization are thought to contribute to postoperative pain. Blocking these receptors and preempting sensitization prevents hyperalgesia leading to lower pain medication requirements. Studies in the orthopedic, urologic, and gynecologic literature support this practice, but the use of preemptive analgesia in anorectal surgery is understudied...
May 15, 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29767648/antinociception-induced-by-copper-salt-revisited-interaction-with-ketamine-in-formalin-induced-intraplantar-and-orofacial-pain-in-mice
#4
Victoria Cazanga, Alejandro Hernandez, Bernardo Morales, Teresa Pelissier, Luis Constandil
AIMS: To evaluate in mice the antinociceptive effect of copper in spinal and trigeminal nociceptive pathways by using the intraplantar and orofacial formalin tests, respectively, and to examine whether this effect may interact synergistically with ketamine-induced antinociception. METHODS: Nociceptive behaviors (licking/biting of the formalin-injected limb and rubbing/scratching of the formalin-injected orofacial area) in male mice were evaluated during a 45-minute observation period post-formalin injection...
May 15, 2018: Journal of Oral & Facial Pain and Headache
https://www.readbyqxmd.com/read/29764182/the-use-of-ketamine-in-a-palliative-supportive-care-unit-a-retrospective-analysis
#5
Sebastiano Mercadante, Amanda Caruselli, Alessandra Casuccio
BACKGROUND: To assess the response to ketamine in patients with difficult pain syndromes. METHODS: The charts of patients with uncontrolled pain despite opioid dose escalation of at least two opioids or a combination of them, selected for a burst of ketamine and midazolam were reviewed. One hundred mg/day of ketamine and midazolam 15 mg/day by a continuous intravenous infusion for about 48 hours was offered to patients. RESULTS: Forty-four patients received a burst of ketamine...
April 2018: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29760856/continuous-intravenous-sub-dissociative-dose-ketamine-infusion-for-managing-pain-in-the-emergency-department
#6
Sergey Motov, Jefferson Drapkin, Antonios Likourezos, Tyler Beals, Ralph Monfort, Christian Fromm, John Marshall
Introduction: Our objective was to describe dosing, duration, and pre- and post-infusion analgesic administration of continuous intravenous sub-dissociative dose ketamine (SDK) infusion for managing a variety of painful conditions in the emergency department (ED). Methods: We conducted a retrospective chart review of patients aged 18 and older presenting to the ED with acute and chronic painful conditions who received continuous SDK infusion in the ED for a period over six years (2010-2016)...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29757924/placebo-versus-low-dose-ketamine-infusion-in-addition-to-remifentanil-target-controlled-infusion-for-conscious-sedation-during-oocyte-retrieval-a-prospective-double-blinded-randomised-controlled-trial
#7
Hélène I Morue, Shalini Raj-Lawrence, Sarah Saxena, Anne Delbaere, Edgard Engelman, Luc A Barvais
BACKGROUND: Currently, there is no gold standard for monitored anaesthesia care during oocyte retrieval. OBJECTIVE: In our institution, the standard is a conscious sedation technique using a target-controlled infusion (TCI) of remifentanil, titrated to maintain a visual analogue pain score less than 30 mm. This protocol is well accepted by patients but is associated with frequent episodes of respiratory depression. The main objective of this study was to evaluate whether the addition of a continuous intravenous infusion of ketamine could reduce these episodes...
April 30, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29753795/non-anesthetic-effects-of-ketamine-a-review-article-authors-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2
#8
REVIEW
Jabril Eldufani, Alireza Nekoui, Gilbert Blaise
Ketamine is considered a dissociative anesthetic medication, and it is a commonly administered by a parenteral route. It works mainly by blocking the N-methyl-D-aspartate (NMDA) receptor. It inhibits the voltage-gated Na_ and K_ channels and serotonin and dopamine re-uptake; also, it affects specific receptors, such as α-amino-3-hydroxy-5-methyl-4- isoxazolepropionic acid (AMPA), kainate and aminobutyric acid A receptors. Ketamine appears to have particular mechanisms that are potentially involved during analgesic induction, including enhancing of descending inhibition and anti-inflammatory effects...
May 10, 2018: American Journal of Medicine
https://www.readbyqxmd.com/read/29739543/special-indications-for-opioid-free-anaesthesia-and-analgesia-patient-and-procedure-related-including-obesity-sleep-apnoea-chronic-obstructive-pulmonary-disease-complex-regional-pain-syndromes-opioid-addiction-and-cancer-surgery
#9
REVIEW
Adrian Sultana, David Torres, Roman Schumann
Opioid-free anaesthesia (OFA) is a technique where no intraoperative systemic, neuraxial or intracavitary opioid is administered with the anaesthetic. Opioid-free analgesia similarly avoids opioids in the perioperative period. There are many compelling reasons to avoid opioids in the surgical population. A number of case reports and, increasingly, prospective studies from all over the world support its benefits, especially in the morbidly obese population with or without sleep apnoea. A derivative technique is opioid sparing, where the same techniques are used but some opioid use is allowed...
December 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29739541/stable-anesthesia-with-alternative-to-opioids-are-ketamine-and-magnesium-helpful-in-stabilizing-hemodynamics-during-surgery-a-systematic-review-and-meta-analyses-of-randomized-controlled-trials
#10
REVIEW
Patrice Forget, Juan Cata
INTRODUCTION: The role of ketamine and magnesium in improving postoperative pain and diminish opioid consumption has been largely described. Synthetic opioids are known to provide hemodynamic stability when given for major noncardiac surgery. Definitive evidence on the role of ketamine and/or magnesium on intraoperative hemodynamic control would support their potential as alternatives to opioids during surgery. METHODS: The available literature published on PubMed/Medline and EMBASE was reviewed systematically to perform meta-analyses of randomized controlled trials (RCTs) assessing the effect of ketamine and/or magnesium on hemodynamic response to surgery as the primary outcome...
December 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29737933/case-report-utility-of-ketamine-lidocaine-and-mexiletine-as-nonopioid-adjuvants-in-complex-cancer-associated-pain
#11
Robert C Hakim, Kyle P Edmonds, Rabia S Atayee
Ketamine, lidocaine, and mexiletine are potential nonopioid adjuvant medications for the use of refractory cancer-related pain, particularly when opioids are demonstrating limited objective benefit. This is a case report of a single patient admitted to a large academic medical center in the United States. The patient is a 43-year-old woman with a history of Crohn's disease complicated by rectal squamous cell carcinoma and complex, progressive, and intractable pelvic and rectal pain. Over the course of hospitalization, her pain demonstrated limited opioid responsiveness despite marked fluctuations of her oral morphine equivalent doses...
May 8, 2018: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/29730359/emerging-trends-in-pain-medication-management-back-to-the-future-a-focus-on-ketamine
#12
REVIEW
Meredith W Crumb, Candace Bryant, Timothy J Atkinson
Providers face many challenges when faced with pain management. Pain is complex, difficult to understand, diagnose, and especially enigmatic to manage. The discovery of non-opioid agents for pain management has become particularly important considering the on-going opioid epidemic. This review is focused on revisiting Ketamine, an agent that has historically been used for anesthesia in new ways to manage pain. Ketamine has unique pharmacologic properties that may prevent the development of pain as well as reduce chronic pain...
May 3, 2018: American Journal of Medicine
https://www.readbyqxmd.com/read/29720754/effects-of-adding-dexamethasone-or-ketamine-to-bupivacaine-for-ultrasound-guided-thoracic-paravertebral-block-in-patients-undergoing-modified-radical-mastectomy-a-prospective-randomized-controlled-study
#13
Mona Blough El Mourad, Asmaa Fawzy Amer
Background and Aims: Pain after modified radical mastectomy (MRM) has been successfully managed with thoracic paravertebral block (TPVB). The purpose of this study was to evaluate the effect of adding dexamethasone or ketamine as adjuncts to bupivacaine in TPVB on the quality of postoperative analgesia in participants undergoing MRM. Methods: This prospective randomised controlled study enrolled ninety adult females scheduled for MRM. Patients were randomised into three groups (30 each) to receive ultrasound-guided TPVB before induction of general anaesthesia...
April 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29716637/is-intravenously-administered-subdissociative-dose-ketamine-non-inferior-to-morphine-for-prehospital-analgesia-the-ketamorph-study-study-protocol-for-a-randomized-controlled-trial
#14
Clément Le Cornec, Said Lariby, Vivien Brenckmann, Jean Benoit Hardouin, Claude Ecoffey, Marion Le Pottier, Philippe Fradin, Hélène Broch, Amine Kabbaj, Yannick Auffret, Florence Deciron, Céline Longo, François Javaudin, Quentin Le Bastard, Joël Jenvrin, Emmanuel Montassier
BACKGROUND: Acute pain is a common condition among prehospital patients and prompt management is pivotal. Opioids are the most frequently analgesics used in the prehospital setting. However, opioids are highly addictive, and some patients may develop opioid dependence, even when they are exposed to brief opioid treatments. Therefore, alternative non-opioid analgesia should be developed to manage pain in the prehospital setting. Used at subdissociative doses, ketamine, a noncompetitive N-methyl-D-aspartate and glutamate receptor antagonist, provides analgesic effects accompanied by preservation of protective airway reflexes...
May 2, 2018: Trials
https://www.readbyqxmd.com/read/29713269/effects-of-subanesthetic-ketamine-administration-on-visual-and-auditory-event-related-potentials-erp-in-humans-a-systematic-review
#15
André Schwertner, Maxciel Zortea, Felipe V Torres, Wolnei Caumo
Ketamine is a non-competitive N-Methyl-D-Aspartate (NMDA) receptor antagonist whose effect in subanesthetic doses has been studied for chronic pain and mood disorders treatment. It has been proposed that ketamine could change the perception of nociceptive stimuli by modulating the cortical connectivity and altering the top-down mechanisms that control conscious pain perception. As this is a strictly central effect, it would be relevant to provide fresh insight into ketamine's effect on cortical response to external stimuli...
2018: Frontiers in Behavioral Neuroscience
https://www.readbyqxmd.com/read/29707324/non-intubated-thoracoscopic-bullectomy-under-sedation-is-safe-and-comfortable-in-the-perioperative-period
#16
Jinwook Hwang, Jae Seung Shin, Joo Hyung Son, Too Jae Min
Background: Non-intubated thoracoscopic surgery can be performed under sedation using adjuvant regional anesthesia, however, the benefits of non-intubated thoracoscopic surgery under sedation have not yet been completely verified. In this study, we compare the perioperative safety and pain complaints of sedation without intubation in thoracoscopic bullectomy with that of conventional general anesthesia with double-lumen intubation and mechanical ventilation. Methods: Forty-one patients with primary spontaneous pneumothorax who were scheduled for thoracoscopic bullectomy were enrolled in this study...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29696126/acute-pain-management-in-emergency-department-low-dose-ketamine-versus-morphine-a-randomized-clinical-trial
#17
Babak Mahshidfar, Mani Mofidi, Maryam Fattahi, Davood Farsi, Peyman Hafezi Moghadam, Saeed Abbasi, Mahdi Rezai
Background: Ketamine, as an opium alternative, has been proposed for pain relief in the emergency department (ED). Objectives: This study was carried out to compare low dose ketamine (LDK) with morphine for pain relief in trauma patients. Methods: In this randomized double-blinded clinical trial, 300 trauma patients from the ED of 2 teaching hospitals in Tehran, Iran were enrolled and randomly divided into 2 equal groups. The 1st group received 0...
December 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29696115/the-effect-of-ketamine-and-dexamethasone-in-combination-with-lidocaine-on-the-onset-and-duration-of-axillary-block-in-hand-and-forearm-soft-tissue-surgery
#18
Behrooz Zaman, Siavash Hojjati Ashrafi, Seyedalireza Seyed Siamdoust, Valiollah Hassani, Siavash Mohamad Taheri, Samad Noorizad
Background: Using peripheral nerve block compared to general anesthesia has gained more popularity due to reduced postoperative pain, less need for post-surgery analgesic drugs, reduced incidence of nausea, shortness of PACU time, and increased patient satisfaction. Objectives: The aim of this study was to compare the effect of ketamine and dexamethasone as additives to lidocaine on duration and onset of axillary block action. Methods: In this clinical trial, all patients who referred to Hazrat-e-Fatemeh hospital for forearm and hand soft tissue surgery with informed consent were randomly divided into three groups in order to examine the onset and duration of axillary block: lidocaine + ketamine, lidocaine + dexamethasone in axillary block, and lidocaine alone (control)...
October 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29695926/pre-emptive-multimodal-analgesia-with-tramadol-and-ketamine-lidocaine-infusion-for-suppression-of-central-sensitization-in-a-dog-model-of-ovariohysterectomy
#19
Ubedullah Kaka, Nor-Alimah Rahman, Adamu Abdul Abubakar, Yong Meng Goh, Sharida Fakurazi, Mohamed Ariff Omar, Hui Cheng Chen
Objectives: The effects of pre-emptive infusion of ketamine-lidocaine with tramadol on the suppression of central sensitization were investigated in a dog ovariohysterectomy model. Patients and methods: Twelve dogs were randomly assigned to two groups: ketamine-lidocaine-tramadol (KLT) and tramadol (T) groups. Both groups received intravenous tramadol 4 mg/kg body weight as premedication. Immediately after induction, the KLT group received ketamine and lidocaine at 0...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29694467/continuous-dentoalveolar-neuropathic-pain-response-to-repeated-intravenous-ketamine-infusions-a-case-report
#20
Isabel Moreno-Hay, John Lindroth
This article describes a case of continuous dentoalveolar neuropathic pain in which relief was obtained following repeated administration of intravenous infusions of a subanesthetic dose of ketamine. A 50-year-old female presented in 2006 with a 1-year history of constant sharp pain in the gingiva surrounding the maxillary left second premolar and second molar rated as 10/10 on a pain intensity scale. After multiple systemic medications failed to adequately manage the patient's pain, partial pain reduction was obtained (4/10) with daily use of methadone 50 mg in combination with application of a topical compound including lidocaine, amitriptyline, and carbamazepine to the affected area as needed...
April 2018: Journal of Oral & Facial Pain and Headache
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