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Ketamine for pain

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https://www.readbyqxmd.com/read/28631150/low-dose-subcutaneous-ketamine-for-postoperative-pain-management-in-rwanda-a-dose-finding-study
#1
Jon Tuchscherer, William P McKay, Theogene Twagirumugabe
PURPOSE: Good pain control is not a normal part of surgical care in sub-Saharan Africa due to lack of resources. The primary objective of this study was to determine an efficacious dose of subcutaneous ketamine for postoperative pain for use in a future randomized controlled trial. METHODS: Following research ethics board and local hospital approval for this research, we obtained informed consent from 31 patients undergoing major surgery for a random walk dose-finding study...
June 19, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28625307/postcesarean-delivery-analgesia
#2
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/28620916/ketamine-does-not-enhance-the-quality-of-recovery-following-laparoscopic-cholecystectomy-a-randomized-controlled-trial
#3
E T Moro, I M P S S Feitosa, R G de Oliveira, G F P Saraiva, R Rosalino, V P Marossi, J A Bloomstone, L H C Navarro
BACKGROUND: Ketamine has been used as part of the multimodal analgesia technique in the acute perioperative period. The effect of perioperative intravenous small-dose ketamine on the quality of recovery from the patient point-of-view has not been assessed. We hypothesized that low-dose ketamine would enhance recovery following laparoscopic cholecystectomy under total intravenous anesthesia. METHODS: One hundred thirty five patients undergoing laparoscopic cholecystectomy were enrolled in this randomized, double-blind placebo-controlled trial...
June 15, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28609318/biochemical-and-pharmacological-characterization-of-a-mice-model-of-complex-regional-pain-syndrome
#4
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
#5
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/28600519/alterations-in-the-inflammatory-cytokines-and-brain-derived-neurotrophic-factor-contribute-to-depression-like-phenotype-after-spared-nerve-injury-improvement-by-ketamine
#6
Ze-Min Xie, Xing-Ming Wang, Ning Xu, Jing Wang, Wei Pan, Xiao-Hui Tang, Zhi-Qiang Zhou, Kenji Hashimoto, Jian-Jun Yang
Although pain is frequently accompanied with depression, little is known about the risk factors contributing to individual differences to the comorbidity of pain and depression. In this study, we examined whether cytokines and brain-derived neurotrophic factor (BDNF) might contribute to the individual differences in the development of neuropathic pain-induced depression. Rats were randomly subjected to spared nerved ligation (SNI) or sham surgery. The SNI rats were divided into two groups by the data from depression-related behavioral tests...
June 9, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28597354/pharmacologic-considerations-for-pediatric-sedation-and-anesthesia-outside-the-operating-room-a-review-for-anesthesia-and-non-anesthesia-providers
#7
REVIEW
Narjeet Khurmi, Perene Patel, Molly Kraus, Terrence Trentman
Understanding the pharmacologic options for pediatric sedation outside the operating room will allow practitioners to formulate an ideal anesthetic plan, allaying anxiety and achieving optimal immobilization while ensuring rapid and efficient recovery. The authors identified relevant medical literature by searching PubMed, MEDLINE, Embase, Scopus, Web of Science, and Google Scholar databases for English language publications covering a period from 1984 to 2017. Search terms included pediatric anesthesia, pediatric sedation, non-operating room sedation, sedation safety, and pharmacology...
June 8, 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/28593930/intra-articular-injections-of-ketamine-and-25-dextrose-improve-clinical-and-pathological-outcomes-in-the-monosodium-iodoacetate-model-of-osteoarthritis
#8
Yashashri C Shetty, Amol E Patil, Sharmila V Jalgaonkar, Nirmala N Rege, Sweta Salgaonkar, Prachi A Teltumbde, Sagar Kshirsagar, Paresh G Koli, Smita Brahma
BACKGROUND: The study evaluated the effect of intra-articular injections of ketamine and 25% dextrose with triamcinolone acetate (TA) and hyaluronic acid (HA) on joint pathology and pain behavior in monosodium iodoacetate (MIA)-induced osteoarthritis (OA) in experimental mice. METHODS: In phase I, the MIA-induced OA model was standardized. In phase II, mice were divided into three groups: disease controls (DC), ketamine 12 mg/kg (K12) and ketamine 24 mg/kg (K24) to select an effective dose of ketamine for phase III...
May 5, 2017: Journal of Basic and Clinical Physiology and Pharmacology
https://www.readbyqxmd.com/read/28576285/intraoperative-ketamine-for-prevention-of-postoperative-delirium-or-pain-after-major-surgery-in-older-adults-an-international-multicentre-double-blind-randomised-clinical-trial
#9
Michael S Avidan, Hannah R Maybrier, Arbi Ben Abdallah, Eric Jacobsohn, Phillip E Vlisides, Kane O Pryor, Robert A Veselis, Hillary P Grocott, Daniel A Emmert, Emma M Rogers, Robert J Downey, Heidi Yulico, Gyu-Jeong Noh, Yonghun H Lee, Christine M Waszynski, Virendra K Arya, Paul S Pagel, Judith A Hudetz, Maxwell R Muench, Bradley A Fritz, Witold Waberski, Sharon K Inouye, George A Mashour
BACKGROUND: Delirium is a common and serious postoperative complication. Subanaesthetic ketamine is often administered intraoperatively for postoperative analgesia, and some evidence suggests that ketamine prevents delirium. The primary purpose of this trial was to assess the effectiveness of ketamine for prevention of postoperative delirium in older adults. METHODS: The Prevention of Delirium and Complications Associated with Surgical Treatments [PODCAST] study is a multicentre, international randomised trial that enrolled adults older than 60 years undergoing major cardiac and non-cardiac surgery under general anaesthesia...
May 30, 2017: Lancet
https://www.readbyqxmd.com/read/28551041/emergency-departments-increasingly-administering-medications-through-the-nose
#10
REVIEW
Deborah L McBride
Administering medications through the nose as an alternative to intramuscular or intravenous injections is increasingly popular in emergency departments and out-of hospital settings because it is simple, fast, and can be used in situations where obtaining intravenous access is difficult or time intensive. This article examines the literature and indications for the out-of-hospital and emergency department administration of five commonly used intranasal medications: midazolam (used to sedate children and treat seizures), fentanyl (for pain relief), naloxone (for opioid overdoses), ketamine (to induce anesthesia) and dexmedetomidine (to sedate and relieve pain in children)...
May 24, 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/28536358/modulation-of-nmda-receptor-activity-in-fibromyalgia
#11
REVIEW
Geoffrey Littlejohn, Emma Guymer
Activation of the N-methyl-d-aspartate receptor (NMDAR) results in increased sensitivity of spinal cord and brain pathways that process sensory information, particularly those which relate to pain. The NMDAR shows increased activity in fibromyalgia and hence modulation of the NMDAR is a target for therapeutic intervention. A literature review of interventions impacting on the NMDAR shows a number of drugs to be active on the NMDAR mechanism in fibromyalgia patients, with variable clinical effects. Low-dose intravenous ketamine and oral memantine both show clinically useful benefit in fibromyalgia...
April 11, 2017: Biomedicines
https://www.readbyqxmd.com/read/28526150/pharmacogenomics-in-pain-management
#12
REVIEW
Ramsey Saba, Alan D Kaye, Richard D Urman
There is interpatient variability to analgesic administration. Much can be traced to pharmacogenomics variations between individuals. Certain ethnicities are more prone to reduced function of CYP2D6. Weak opioids are subject to interpatient variation based on their CYP2D6 type. Strong opioids have variations based on their transport and individual metabolism. Several cytochrome enzymes have been found to be involved with ketamine but there is no strong evidence of individual polymorphisms manifesting in clinical outcomes...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28525529/is-intravenous-ketamine-effective-for-postoperative-pain-management-in-adults
#13
Camila Stuardo, Diego Lobos-Urbina, Fernando Altermatt
Ketamine is a N-Metil-D-Aspartate receptor antagonist that has been used as adjuvant in the acute postoperative pain management because of its analgesic properties. However, its role is not clearly determined. To answer this question, we searched in Epistemonikos database, which is maintained by screening multiple information sources. We identified 19 systematic reviews including 226 randomized trials overall. We extracted data and generated a summary of findings table using the GRADE approach. We concluded intravenous ketamine probably has little or no effect in reducing postoperative pain...
May 17, 2017: Medwave
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
#14
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
#15
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/28489643/factors-influencing-quality-of-pain-management-in-a-physician-staffed-helicopter-emergency-medical-service
#16
Nicole Oberholzer, Alexander Kaserer, Roland Albrecht, Burkhardt Seifert, Mario Tissi, Donat R Spahn, Konrad Maurer, Philipp Stein
BACKGROUND: Pain is frequently encountered in the prehospital setting and needs to be treated quickly and sufficiently. However, incidences of insufficient analgesia after prehospital treatment by emergency medical services are reported to be as high as 43%. The purpose of this analysis was to identify modifiable factors in a specific emergency patient cohort that influence the pain suffered by patients when admitted to the hospital. METHODS: For that purpose, this retrospective observational study included all patients with significant pain treated by a Swiss physician-staffed helicopter emergency service between April and October 2011 with the following characteristics to limit selection bias: Age > 15 years, numerical rating scale (NRS) for pain documented at the scene and at hospital admission, NRS > 3 at the scene, initial Glasgow coma scale > 12, and National Advisory Committee for Aeronautics score < VI...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28474988/premedication-with-fentanyl-midazolam-improves-sevoflurane-anesthesia-for-surgical-intervention-in-laboratory-mice
#17
Miriam Lipiski, Margarete Arras, Paulin Jirkof, Nikola Cesarovic
Balanced anesthesia allows for a reduced dosage of each component, while inducing general anesthesia of sufficient depth with potentially fewer side effects. Here, we compare two anesthetic protocols combining sevoflurane anesthesia with pre-medication (ketamine [K] or fentanyl-midazolam [FM]) to a sevoflurane monoanesthesia (S) concerning their ability to provide reliable anesthesia suitable for moderate surgery in laboratory mice. Twenty-one female C57BL/6J mice assigned randomly to one of three protocols underwent a 50-min anesthesia and a sham embryo transfer...
January 1, 2017: Experimental Biology and Medicine
https://www.readbyqxmd.com/read/28469132/population-scale-data-reveals-the-antidepressant-effects-of-ketamine-and-other-therapeutics-approved-for-non-psychiatric-indications
#18
Isaac V Cohen, Tigran Makunts, Rabia Atayee, Ruben Abagyan
Current therapeutic approaches to depression fail for millions of patients due to lag in clinical response and non-adherence. Here we provide new support for the antidepressant effect of an anesthetic drug, ketamine, by Inverse-Frequency Analysis of eight million reports from the FDA Adverse Effect Reporting System. The results of the examination of population scale data revealed that patients who received ketamine had significantly lower frequency of reports of depression than patients who took any other combination of drugs for pain...
May 3, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28468999/ketamine-induced-converged-synchronous-gamma-oscillations-in-the-cortico-basal-ganglia-network-of-non-human-primates
#19
Maya Slovik, Boris Rosin, Shay Moshel, Rea Mitelman, Eitan Schechtman, Renana Eitan, Aeyal Raz, Hagai Bergman
NMDA (N-methyl-D-aspartate) antagonists are widely used in anesthesia, pain management, schizophrenia animal model studies and recently as potential antidepressants. However the mechanisms underlying their anesthetic, psychotic, cognitive and emotional effects are still elusive. The basal-ganglia (BG) integrate input from different cortical domains through its dopamine modulated connections, to achieve optimal behavior control. NMDA antagonists have been shown to induce gamma oscillations in human EEG recordings and in rodents cortical and BG networks...
May 3, 2017: Journal of Neurophysiology
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
#20
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
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