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Ketamine for pain

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https://www.readbyqxmd.com/read/28306568/ketamine-for-cancer-pain-what-is-the-evidence
#1
Kelly Jonkman, Tine van de Donk, Albert Dahan
PURPOSE OF REVIEW: In this review, we assess the benefit of ketamine in the treatment of terminal cancer pain that is refractory to opioid treatment and/or complicated by neuropathy. RECENT FINDINGS: While randomized controlled trials consistently show lack of clinical efficacy of ketamine in treating cancer pain, a large number of open-label studies and case series show benefit. SUMMARY: Ketamine is an N-methyl-D-aspartate receptor antagonist that at low-dose has effective analgesic properties...
March 16, 2017: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/28299720/ketamine-infusion-as-a-counter-measure-for-opioid-tolerance-in-mechanically-ventilated-children-a-pilot-study
#2
Felix Neunhoeffer, Anja Hanser, Martin Esslinger, Vanja Icheva, Matthias Kumpf, Ines Gerbig, Michael Hofbeck, Jörg Michel
BACKGROUND: Drug rotation to prevent opioid tolerance is well recognized in chronic pain management. However, ketamine infusion as a counter measure for opioid tolerance is rarely described in mechanically ventilated children developing tolerance from prolonged opioid infusion. PATIENTS AND METHODS: We performed a retrospective study in a 14-bed medical-surgical-cardiac pediatric intensive care unit. Thirty-two mechanically ventilated children who had developed tolerance from prolonged intravenous infusion of opioids received a continuous intravenous infusion of ketamine as an opioid substitute for more than 2 days, scheduled in a drug rotation protocol...
March 15, 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/28296748/efficacy-of-lidocaine-on-preventing-incidence-and-severity-of-pain-associated-with-propofol-using-in-pediatric-patients-a-prisma-compliant-meta-analysis-of-randomized-controlled-trials
#3
Bing-Chen Lang, Chun-Song Yang, Ling-Li Zhang, Wen-Sheng Zhang, Yu-Zhi Fu
BACKGROUND: Propofol injection pain was considered as one conundrum during clinical anesthesia. The systematic review about the effect of lidocaine in reducing injection pain among children has not been established. The aim of the study was to systematically evaluate the efficacy and safety of such intervention. METHODS: The literature search was performed from the inception to the May 31, 2016 in PubMed, Ovid EMBASE, and Cochrane database. All randomized controlled trials that using lidocaine for propofol injection pain in children were enrolled...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28286933/the-effect-of-nephrostomy-tract-infiltration-of-ketamine-on-postoperative-pain-and-peak-expiratory-flow-rate-in-patients-undergoing-tubeless-percutaneous-nephrolithotomy-a-prospective-randomized-clinical-trial
#4
Seyed Reza Hosseini, Farsad Imani, Golnar Shayanpour, Mohammad Reza Khajavi
Ketamine, as a systemic and local analgesic, has been used to reduce postoperative pain in many studies. The present study was designed to assess the analgesic efficacy of nephrostomy tract infiltration of ketamine in postoperative pain after tubeless percutaneous nephrolithotomy (PCNL). Sixty-six patients with renal stone who were candidates for PCNL were randomized to two groups with 33 patients in each group. In group K, 20 mL saline solution containing 1.5 mg/kg ketamine was infiltrated into the nephrostomy tract and in group C, 20 mL saline solution was infiltrated into the nephrostomy tract at the end of surgery...
March 12, 2017: Urolithiasis
https://www.readbyqxmd.com/read/28285863/low-dose-ketamine-use-in-the-emergency-department-a-new-direction-in-pain-management
#5
A Pourmand, M Mazer-Amirshahi, C Royall, R Alhawas, R Shesser
There is a need for alternative non-opioid analgesics for the treatment of acute, chronic, and refractory pain in the emergency department (ED). Ketamine is a fast acting N-methyl-d-aspartate (NMDA) receptor antagonist that provides safe and effective analgesia. The use of low dose ketamine (LDK) (<1mg/kg) provides sub-dissociative levels of analgesia and has been studied as an alternative and/or adjunct to opioid analgesics. We reviewed 11 studies using LDK either alone or in combination with opioid analgesics in the ED...
March 2, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28283340/a-prospective-randomized-double-dummy-trial-comparing-intravenous-push-dose-of-low-dose-ketamine-to-short-infusion-of-low-dose-ketamine-for-treatment-of-moderate-to-severe-pain-in-the-emergency-department
#6
Sergey Motov, Mo Mai, Illya Pushkar, Antonios Likourezos, Jefferson Drapkin, Matthew Yasavolian, Jason Brady, Peter Homel, Christian Fromm
STUDY OBJECTIVE: Compare adverse effects and analgesic efficacy of low-dose ketamine for acute pain in the ED administered either by single intravenous push (IVP) or short infusion (SI). METHODS: Patients 18-65, presenting to ED with acute abdominal, flank, or musculoskeletal pain with initial pain score≥5, were randomized to ketamine 0.3mg/kg by either IVP or SI with placebo double-dummy. Adverse effects were evaluated by Side Effects Rating Scale for Dissociative Anesthetics (SERSDA) and Richmond Agitation-Sedation Scale (RASS) at 5, 15, 30, 60, 90, and 120min post-administration; analgesic efficacy was evaluated by Numerical Rating Scale (NRS)...
March 3, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28282425/administration-of-tranexamic-acid-to-patients-undergoing-surgery-for-adolescent-idiopathic-scoliosis-evokes-pain-and-increases-the-infusion-rate-of-remifentanil-during-the-surgery
#7
Nobuko Ohashi, Masayuki Ohashi, Naoto Endo, Tatsuro Kohno
BACKGROUND: We recently reported that tranexamic acid (TXA) evokes pain in rats by inhibiting γ-aminobutyric acid and glycine receptors on neurons in the spinal dorsal horn. Although TXA is commonly used to reduce perioperative blood loss during various surgeries, its potential to induce intraoperative nociception, thereby increasing the need for more analgesics during surgery, has not been investigated. Therefore, this study aimed to investigate whether TXA evokes pain and increases the need for a higher infusion rate of remifentanil in patients undergoing surgery for adolescent idiopathic scoliosis (AIS)...
2017: PloS One
https://www.readbyqxmd.com/read/28282236/comparison-of-morphine-morphine-lidocaine-and-morphine-lidocaine-ketamine-infusions-in-dogs-using-an-incision-induced-pain-model
#8
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
#9
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/28271334/topical-treatments-for-localized-neuropathic-pain
#10
REVIEW
Roberto Casale, Z Symeonidou, M Bartolo
PURPOSE OF REVIEW: Topical therapeutic approaches in localized neuropathic pain (LNP) syndromes are increasingly used by both specialists and general practitioners, with a potentially promising effect on pain reduction. In this narrative review, we describe the available compounds for topical use in LNP syndromes and address their potential efficacy according to the literature. RECENT FINDINGS: Local anaesthetics (e.g., lidocaine, bupivacaine and mepivacaine), as well as general anaesthetic agents (e...
March 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28251524/pain-management-of-patients-with-substance-abuse-in-the-ambulatory-setting
#11
REVIEW
Nalini Vadivelu, Alice M Kai, Vijay Kodumudi, Richard Zhu, Roberta Hines
PURPOSE OF REVIEW: Abuse of illicit substances and prescription opioids is a growing problem that presents challenges for pain management in the inpatient and outpatient setting. With future patient care models shifting toward shorter hospital stays and more same-day surgeries, it is crucial that clinicians learn to manage this patient population and strike a balance between the overtreatment of pain that can subsequently worsen tolerance and addiction, and the undertreatment of pain that can lead to pseudoaddiction...
February 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28246760/-side-effects-of-pain-therapy-sufficient-analgesia-without-unnecessary-complications
#12
F Greul, A Zimmer, W Meißner
Interventions of acute and chronic pain treatment are associated with risks. Therefore, it is important to know about treatment side effects in order to avoid unnecessary complications and therapy interruption. This knowledge, however, is not to prevent/abandon this treatment altogether. Rather, it is intended to use pain treatment interventions rationally. The following article is to deepen the knowledge of unintended effects of analgetic treatments. Moreover, it will help find an optimal pain therapy in terms of efficacy and tolerable risks as well as limitations...
February 28, 2017: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/28240366/high-patient-satisfaction-with-deep-sedation-for-catheter-ablation-of-cardiac-arrhythmia
#13
Paula Münkler, Philipp Attanasio, Abdul Shokor Parwani, Martin Huemer, Leif-Hendrik Boldt, Wilhelm Haverkamp, Alexander Wutzler
Patients' satisfaction with invasive procedures largely relies on periprocedural perception of pain and discomfort. The necessity for intraprocedural sedation during catheter ablation of cardiac arrhythmias for technical reasons is widely accepted, but data on patients' experience of pain and satisfaction with the procedural sedation are scarce. We have assessed patients' pain and discomfort during and after the procedure using a standardized questionnaire. One-hundred seventeen patients who underwent catheter ablation answered a standardized questionnaire on periprocedural perception of pain and discomfort after different anesthetic protocols with propofol/midazolam with and without additional piritramide and ketamine/midazolam...
February 27, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28237682/the-influence-of-demeanor-on-scores-from-two-validated-feline-pain-assessment-scales-during-the-perioperative-period
#14
Mandy Buisman, Michelle M M Hasiuk, Marta Gunn, Daniel S J Pang
OBJECTIVE: To evaluate the effects of demeanor on validated pain assessment scales. STUDY DESIGN: Prospective, blind, clinical trial. ANIMAL POPULATION: Thirty three adult domestic cats scheduled for orchiectomy. METHODS: Cats were assessed for pain pre (baseline) and 1, 2, 4 hours postoperatively using two validated pain scales [Composite Measures Pain Scale-Feline (rCMPS-F) and UNESP-Botucatu multidimensional composite pain scale (psychomotor and pain expression subscales; U-B MCPS-psych and -painex)], and a demeanor scale...
January 8, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28222143/antidepressive-and-antinociceptive-effects-of-ethanolic-extract-and-fruticuline-a-from-salvia-lachnostachys-benth-leaves-on-rodents
#15
Joyce Alencar Santos, Ana Claudia Piccinelli, Maira Dante Formagio, Cristhian Santos Oliveira, Elide Pereira Dos Santos, Maria Élida Alves Stefanello, Ubirajara Lanza Junior, Rodrigo Juliano Oliveira, Mário Mateus Sugizaki, Cândida Aparecida Leite Kassuya
OBJECTIVES: This study investigated the antidepressant and antinociceptive effects of ethanolic extract (SLEE) and pure fruticuline A obtained from Salvia lachnostachys leaves on rats and mice. METHODS: In this study, SLEE (100 mg/kg, p.o. route) was evaluated for its effects on spared nerve injury (SNI) in rats. The animals were submitted to mechanical sensitivity, forced swim (FST) and cold sensitivity tests 10 and 15 days after surgery. SLEE (100 mg/kg, p.o.) and fruticuline A (3 mg/kg, p...
2017: PloS One
https://www.readbyqxmd.com/read/28217052/topical-versus-caudal-ketamine-bupivacaine-combination-for-postoperative-analgesia-in-children-undergoing-inguinal-herniotomy
#16
Hala Saad Abdel-Ghaffar, Seham Mohamed Moeen, Ahmed Mohamed Moeen
BACKGROUND: Multiple studies claim that caudal administration of ketamine causes effective postoperative analgesia. The aim of this study was to assess the clinical effectiveness of ketamine after caudal or topical administration in pediatric patients undergoing inguinal herniotomy. PATIENTS AND METHODS: This randomized, comparative, double-blind study included eighty children (aged 6 months to 6 years) received either 1 ml/kg of 0.25% bupivacaine/ketamine 0.5 mg/kg for caudal analgesia (caudal group) or 0...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28216871/role-of-ketamine-and-methadone-as-adjunctive-therapy-in-complex-pain-management-a-case-report-and-literature-review
#17
Wasek Faisal, Judith Jacques
Assessment and management of complex cancer pain always remains a major challenge for any palliative care team, given its heterogeneity of underlying pathophysiology and limitations of any pharmacotherapy. Here, we present a case of complex pain management in a young patient with a life-limiting illness, highlighting the issues of organic and nonorganic contributors of pain and provide some insight into the role of ketamine and methadone as adjunctive therapy to opioid analgesics. A brief literature review is also done to provide the context of use of these adjunctive drugs in this setting...
January 2017: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/28194274/moderate-to-deep-sedation-technique-using-propofol-and-ketamine-allowing-synchronised-breathing-for-magnetic-resonance-high-intensity-focused-ultrasound-mr-hifu-treatment-for-uterine-fibroids-a-pilot-study
#18
Hermanus H B Vaessen, F M Knuttel, J M M van Breugel, M E Ikink, J M Dieleman, M A A J van den Bosch, J T A Knape
BACKGROUND: Magnetic resonance high-intensity focused ultrasound (MR-HIFU) treatment for uterine fibroids is rapidly gaining popularity as a treatment modality. This procedure is generally uncomfortable, painful, and requires minimal or absence of movement and an MR-HIFU synchronised breathing pattern of the patient. Procedural sedation and analgesia protocols have become the standard practice in interventional radiology departments worldwide. The aim of this study was to explore if a sedation regimen with low-dose propofol and ketamine performed by trained non-medical sedation practitioners could result in relief of discomfort for the patient and in adequate working conditions for MR-HIFU treatment for uterine fibroids...
2017: Journal of Therapeutic Ultrasound
https://www.readbyqxmd.com/read/28183297/the-relationship-between-pain-with-walking-and-self-rated-health-12%C3%A2-months-following-total-knee-arthroplasty-a-longitudinal-study
#19
Maren Falch Lindberg, Tone Rustøen, Christine Miaskowski, Leiv Arne Rosseland, Anners Lerdal
BACKGROUND: A subgroup of patients continue to report pain with walking 12 months after total knee arthroplasty (TKA). The association between walking pain and self-rated health (SRH) after TKA is not known. This prospective longitudinal study aimed to investigate the association between a comprehensive list of preoperative factors, postoperative pain with walking, and SRH 12 months after TKA. METHODS: Patients (N = 156) scheduled for TKA completed questionnaires that evaluated demographic and clinical characteristics, symptoms, psychological factors, and SRH...
February 10, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28177167/ketamine-as-an-adjunct-to-opioids-for-acute-pain-in-the-emergency-department-a-randomized-controlled-trial
#20
Karen J Bowers, Kelly B McAllister, Meredith Ray, Corey Heitz
OBJECTIVES: This study had five objectives: 1) to measure and compare total opioid use and number of opioid doses in patients treated with opioids versus ketamine in conjunction with opioids. 2) To measure pain scores up to 2 hours after presentation in the ED patient with pain, comparing standard opioid pain control to ketamine in conjunction with opioids. 3) To compare patient satisfaction with pain control using opioids alone versus ketamine in conjunction with opioids. 4) To monitor and compare side effects in patients treated with opioids versus ketamine in conjunction with opioids...
February 8, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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