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Ketamine for pain

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https://www.readbyqxmd.com/read/29150087/dexmedetomidine-methadone-ketamine-versus-dexmedetomidine-methadone-alfaxalone-for-cats-undergoing-ovariectomy
#1
Rocio Fernandez-Parra, Chiara Adami, Thomas Dresco, Thomas M Donnelly, Luca Zilberstein
OBJECTIVE: To compare the duration, quality of anaesthesia and analgesia, and quality of recovery of dexmedetomidine and methadone combined with either ketamine or alfaxalone. STUDY DESIGN: Randomized, prospective clinical trial. ANIMALS: A group of 44 healthy client-owned cats presenting for ovariectomy. METHODS: Cats were randomly assigned to one of the two treatment groups: DAM (n=22), which was administered intramuscularly (IM) dexmedetomidine (15 μg kg(-1)), methadone (0...
May 27, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29142185/anesthesia-procedure-for-congenital-insensitivity-to-pain-in-a-child-with-anhidrosis-syndrome-a-rare-case
#2
Aykut Urfalioglu, Mahmut Arslan, Yakup Duman, Gökce Gisi, Gözen Oksuz, Hüseyin Yildiz, Hafize Oksuz, Ayşe Balaban
Congenital insensitivity to pain with anhidrosis (CIPA) syndrome is a neuropathy characterized by insensitivity to pain, impaired thermoregulation, anhidrosis, and mental retardation. A 9-year old boy with CIPA syndrome, underwent 2 operations for a calcaneal ulcer. During the first operation standard monitorization was performed. In the second operation, Bispectral Index (BIS) monitoring was added and temperature was monitored with an esophageal probe. In the first operation, in which anesthesia induction was applied with ketamine and midazolam, extremity movements with surgical stimuli were seen...
2017: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
https://www.readbyqxmd.com/read/29135531/recurrent-subanesthetic-ketamine-infusions-for-complex-regional-pain-syndrome-leading-to-biliary-dilation-jaundice-and-cholangitis-a-case-report
#3
Nathan A Hewitt, Peter Cox
Complex regional pain syndrome is a chronic pain condition that may be resistant to many treatment modalities. Ketamine infusions have demonstrated some promising results, though their use may be associated with a number of adverse effects limiting their widespread applicability. Hepatotoxicity and cholangiopathy have been described in chronic ketamine abuse, though rarely in therapeutic use. We report the impact of recurrent short subanesthetic ketamine infusions for the treatment of complex regional pain syndrome resulting in biliary dilation, jaundice, and cholangitis...
November 9, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29134517/subcutaneous-ketamine-for-postoperative-pain-relief-in-rwanda-a-randomized-clinical-trial
#4
Calen Sacevich, Benjamin Semakuba, William P McKay, Shefali Thakore, Theogene Twagirumugabe, John Nyiligira
PURPOSE: Postoperative pain control is often inadequate in low-income countries such as Rwanda, prompting the search for an inexpensive improvement. A randomized controlled trial was conducted to study the use of subcutaneous ketamine for the management of postoperative pain in patients undergoing major surgery in Kigali, Rwanda. METHODS: Fifty-nine patients undergoing major abdominal, head and neck, plastic, or gynecological surgeries were studied. In addition to standard care, patients received five subcutaneous injections of ketamine 1 mg·kg(-1) (ketamine group, n = 30) or normal saline (placebo group, n = 29) during the postoperative period...
November 13, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29133582/use-of-ketamine-for-acute-suicidal-ideation-in-a-patient-with-chronic-pain-on-prescribed-cannabinoids
#5
Daniel Bigman, Sindhura Kunaparaju, Bradford Bobrin
Ketamine is a standard anaesthetic drug that has been studied as a possible treatment for acute suicidal ideation. Aside to the potential psychotropic effects of ketamine, a Cochrane review reported that available studies suggest a modest effect of ketamine for chronic pain months to years after surgical intervention. We present a patient with acute suicidal ideation who required immediate inpatient psychiatric admission in the setting of concurrent chronic pain on cannabinoids which could not be prescribed within our inpatient hospital setting...
November 12, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29127600/a-review-of-current-and-emerging-approaches-to-pain-management-in-the-emergency-department
#6
REVIEW
Knox H Todd
INTRODUCTION: Pain is the most common symptom prompting an emergency department visit and emergency physicians are responsible for managing both acute pain and acute exacerbations of chronic pain resulting from a broad range of illnesses and injuries. The responsibility to treat must be balanced by the duty to limit harm resulting from analgesics. In recent years, opioid-related adverse effects, including overdose and deaths, have increased dramatically in the USA. In response to the US opioid crisis, emergency physicians have broadened their analgesic armamentarium to include a variety of non-opioid approaches...
December 2017: Pain and Therapy
https://www.readbyqxmd.com/read/29125423/management-of-chronic-neuropathic-pain-with-single-and-compounded-topical-analgesics
#7
Nebojsa Nick Knezevic, Tatiana Tverdohleb, Farid Nikibin, Ivana Knezevic, Kenneth D Candido
The goal of our review was to emphasize important aspects that physicians should take into consideration when prescribing topical analgesics as part of chronic neuropathic pain treatment. We discuss the dermatopharmacokinetics and microstructural components of the skin, differences between topical and transdermal drug delivery, and topical medication effects on peripheral neuropathy and central sensitization. Even though the US FDA approved topical analgesics are 8%-capsaicin and 5%-lidocaine patches for treating postherpetic neuralgia, there are many other studies conducted on the efficacy of topical ketamine cream, clonidine gel, topical gabapentin, topical baclofen and topical phenytoin for peripheral neuropathic pain, either alone or in combination with other formulations...
November 10, 2017: Pain Management
https://www.readbyqxmd.com/read/29124992/efficacy-of-ketamine-for-postoperative-pain-following-robotic-thyroidectomy-a-prospective-randomised-study
#8
Jiwon Lee, Hee-Pyoung Park, Mu-Hui Jeong, Je-Do Son, Hyun-Chang Kim
Objective Although robotic thyroidectomy (RoT) is a minimally invasive surgery, percutaneous tunneling causes moderate to severe pain immediately postoperatively. We evaluated the efficacy of ketamine for postoperative pain management in patients following RoT. Methods Sixty-four patients scheduled for RoT were randomly divided into two groups. In the ketamine group (n = 32), ketamine was infused from induction of anaesthesia until the end of the procedure (0.15-mg/kg bolus with continuous infusion at 2 µg/kg/min)...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/29123660/does-perioperative-ketamine-have-a-role-in-the-prevention-of-chronic-postsurgical-pain-the-rocket-trial
#9
Stephan A Schug, Philip Peyton
Identifying operations and individuals with an increased risk of chronic postsurgical pain (CPSP) has led to significant interest in interventions with the potential to achieve primary prevention of this condition. Pharmacological prevention remains controversial with a Cochrane review identifying perioperative ketamine administration as the only intervention with possible benefit although, with only small, heterogeneous studies, the authors called for a large randomised controlled trial (RCT) to confirm the validity of this result...
November 2017: British Journal of Pain
https://www.readbyqxmd.com/read/29100524/effect-of-ketamine-combined-with-magnesium-sulfate-in-neuropathic-pain-patients-ketapain-study-protocol-for-a-randomized-controlled-trial
#10
Noémie Delage, Véronique Morel, Pascale Picard, Fabienne Marcaillou, Bruno Pereira, Gisèle Pickering
BACKGROUND: Neuropathic pain is difficult to treat, and the efficacy of recommended drugs remains limited. N-methyl-D-aspartate receptors are implicated, and antagonists are a pharmacological option. Ketamine is widely used in French pain clinics, but without consensus or recommendations. Furthermore, the association of ketamine with magnesium has been poorly studied. The aim of the present study is to evaluate the benefit of ketamine with or without magnesium in refractory neuropathic pain...
November 3, 2017: Trials
https://www.readbyqxmd.com/read/29099938/nyx-2925-is-a-novel-nmda-receptor-specific-spirocyclic-%C3%AE-lactam-that-modulates-synaptic-plasticity-processes-associated-with-learning-and-memory
#11
M Amin Khan, David R Houck, Amanda L Gross, Xiao-Lei Zhang, Cassia Cearley, Torsten M Madsen, Roger A Kroes, Patric K Stanton, Jeffrey Burgdorf, Joseph R Moskal
Background: N-methyl-D-aspartate receptors (NMDAR) are one member of a family of ionotropic glutamate receptors that play a pivotal role in synaptic plasticity processes associated with learning and have become attractive therapeutic targets for diseases such as depression, anxiety, schizophrenia, and neuropathic pain. NYX-2925 ((2S, 3R)-3-hydroxy-2-((R)-5-isobutyryl-1-oxo-2,5-diazaspiro[3.4]octan-2-yl)butanamide) is one member of a spiro--lactam-based chemical platform that mimics some of the dipyrrolidine structural features of rapastinel (formerly GLYX-13: threonine-proline-proline-threonine) and is distinct from known NMDAR agonists or antagonists such as D-cycloserine, ketamine, MK-801, kynurenic acid or ifenprodil...
November 1, 2017: International Journal of Neuropsychopharmacology
https://www.readbyqxmd.com/read/29062346/effect-of-low-dose-ketamine-on-post-operative-serum-il-6-production-among-elective-surgical-patients-a-randomized-clinical-trial
#12
Tonny Stone Luggya, Tony Roche, Lameck Ssemogerere, Andrew Kintu, John Mark Kasumba, Arthur Kwizera, Jose Vb Tindimwebwa
BACKGROUND: Surgery and Anesthesia cause an excessive pro-inflammatory response. Mulago Hospital is faced with staff shortage making post-operative pain management difficult.Interleukin-6 (IL-6) drives inflammatory pain, endothelial cell dysfunction and fibrogenesis. Ketamine is cheap and, readily available. We hypothesized that its attenuation of serum IL-6 was a surrogate for clinical benefit. MATERIALS AND METHODS: Institutional Review Board's approval was sought and RCT was registered at clinical trials...
June 2017: African Health Sciences
https://www.readbyqxmd.com/read/29049110/evidence-for-the-efficacy-of-systemic-opioid-sparing-analgesics-in-pediatric-surgical-populations-a-systematic-review
#13
REVIEW
Alyssa Zhu, Hubert A Benzon, T Anthony Anderson
While a large number of studies has examined the efficacy of opioid-sparing analgesics in adult surgical populations, fewer studies are available to guide postoperative pain treatment in pediatric patients. We systematically reviewed available publications on the use of systemic nonopioid agents for postoperative analgesia in pediatric surgical populations. A comprehensive literature search identified meta-analyses and randomized controlled trials (RCTs) assessing the effects of systemic, nonopioid agents on postoperative narcotic requirements or pain scores in pediatric surgical populations...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29045243/use-of-ketamine-in-a-multimodal-analgesia-setting-for-rapid-opioid-tapering-in-a-profoundly-opioid-tolerant-patient-a-case-report
#14
Elise M Strickler, Eric S Schwenk, Mitchell J Cohen, Eugene R Viscusi
Opioids are frequently used for the treatment of chronic pain, and patients taking high doses are at increased risk of complications and adverse opioid-related events. Ketamine is appealing as an opioid adjunct because of its lack of respiratory depression and potential prevention of hyperalgesia and central sensitization. We present a case in which a ketamine infusion was utilized over a 7-day period to provide rapid taper of a daily dose of 400 mg of morphine equivalents to less than one-third of that dose on discharge with unchanged pain levels and no symptoms of opioid withdrawal...
October 17, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29033296/a-comparison-of-headache-treatment-in-the-emergency-department-prochlorperazine-versus%C3%A2-ketamine
#15
Tony Zitek, Melanie Gates, Christopher Pitotti, Alexandria Bartlett, Jayme Patel, Aryan Rahbar, Wesley Forred, Joseph S Sontgerath, Jill M Clark
STUDY OBJECTIVE: Intravenous subdissociative-dose ketamine has been shown to be effective for pain management, but has not been specifically studied for headaches in the emergency department (ED). For this reason, we designed a study to compare standard treatment (prochlorperazine) with ketamine in patients with benign headaches in the ED. METHODS: This study was a multicenter, double-blind, randomized, controlled trial with a convenience sample of patients presenting to the ED with benign headaches...
October 13, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29026385/a-randomized-controlled-trial-to-assess-the-effect-of-a-ketamine-infusion-on-tourniquet-hypertension-during-general-anaesthesia-in-patients-undergoing-upper-and-lower-limb-surgery
#16
Joyce Ongaya, Vitalis Mung'ayi, Thikra Sharif, Jimmie Kabugi
BACKGROUND: Tourniquet hypertension arising from tourniquet inflation remains a primary concern to the anaesthetist. One drug commonly used to manage tourniquet hypertension is ketamine. No studies have examined the effect of ketamine on tourniquet hypertension for a period of more than one hour or an infusion of the same. OBJECTIVE: To compare the effect of an intravenous infusion of ketamine versus placebo on tourniquet induced hypertension in patients undergoing upper and lower limb surgery under general anaesthesia...
March 2017: African Health Sciences
https://www.readbyqxmd.com/read/29025089/oral-ketamine-for-acute-pain-management-after-amputation-surgery
#17
Asokumar Buvanendran, Jeffrey S Kroin, Arvind Rajagopal, Sherry J Robison, Mario Moric, Kenneth J Tuman
Objective: Intravenous ketamine has been shown to provide postoperative analgesia in many clinical trials, in particular to reduce opioid consumption. The primary objective of this pilot study is to determine if multiple dosing over a three-day perioperative period with oral ketamine is a safe treatment method for acute pain after amputation surgery. Methods: Three consented subjects (age 57-60 years) undergoing elective amputation of the lower extremity were included in the study (Institutional Review Board and Food and Drug Administration Investigational New Drug approved)...
September 14, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29023898/impact-of-ketamine-use-on-adjunctive-analgesic-and-sedative-medications-in-critically-ill-trauma-patients
#18
Kaitlin A Pruskowski, Kelly Harbourt, Mehrnaz Pajoumand, Sai-Ho Jason Chui, H Neal Reynolds
BACKGROUND: Ketamine may be used to manage pain and agitation that is refractory to "traditional" agents such as fentanyl, propofol, benzodiazepines, and dexmedetomidine; however, literature describing the use of ketamine continuous infusions for this purpose in critically ill trauma patients is limited. OBJECTIVES: The primary objective of this study was to determine the impact of the initiation of a ketamine continuous infusion on sedative and analgesic use in critically ill trauma patients...
October 10, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28994672/low-dose-intravenous-ketamine-for-postcardiac-surgery-pain-effect-on-opioid-consumption-and-the-incidence-of-chronic-pain
#19
Jennifer Cogan, Geneviève Lalumière, Grisell Vargas-Schaffer, Alain Deschamps, Zeynep Yegin
BACKGROUND: Recent meta-analyses have concluded that low-dose intravenous ketamine infusions (LDKIs) during the postoperative period may help to decrease acute and chronic postoperative pain after major surgery. AIMS: This study aims to evaluate the level of pain at least 3 months after surgery for patients treated with a postoperative LDKI versus patients who were not treated with a postoperative LDKI. METHODS: Administrative and Ethics Board approval were obtained for this study...
October 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28979762/ketamine-for-pain
#20
REVIEW
Kelly Jonkman, Albert Dahan, Tine van de Donk, Leon Aarts, Marieke Niesters, Monique van Velzen
The efficacy of the N-methyl-D-aspartate receptor antagonist ketamine as an analgesic agent is still under debate, especially for indications such as chronic pain. To understand the efficacy of ketamine for relief of pain, we performed a literature search for relevant narrative and systematic reviews and meta-analyses. We retrieved 189 unique articles, of which 29 were deemed appropriate for use in this review. Ketamine treatment is most effective for relief of postoperative pain, causing reduced opioid consumption...
2017: F1000Research
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