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ketamine epidural

Zuhair Bani Ismail
Epidural analgesia is commonly used in large animals. It is an easy, cheap, and effective technique used to prevent or control pain during surgeries involving the tail, anus, vulva, perineum, caudal udder, scrotum, and upper hind limbs. The objectives of this article were to comprehensively review and summarize all scientific data available in the literature on new techniques and drugs or drug combinations used for epidural anesthesia in cattle, camel, and buffalo. Only articles published between 2006 and 2016 were included in the review...
December 2016: Veterinary World
Berenice Carolina Hernández-Porras, Ricardo Plancarte-Sánchez, Silvia Alarcón-Barrios, Marcela Sámano-García
BACKGROUND: Complex regional pain syndrome is characterized by spontaneous or induced pain disproportionate in relation to the initial event and is accompanied by a variety of regional and motor disturbances, leading to a variety of clinical presentations. It is often associated with surgery and minor trauma. PATHOPHYSIOLOGY: Three mechanisms are postulated: changes secondary to post traumatic inflammation, peripheral vasomotor dysfunction and structural and functional changes of the central nervous system as a result of maladaptation...
December 19, 2016: Cirugia y Cirujanos
Hou-Chuan Lai, Chung-Bao Hsieh, Chih-Shung Wong, Chun-Chang Yeh, Zhi-Fu Wu
OBJECTIVE(S): Previous studies have shown that preincisional epidural morphine, bupivacaine, and ketamine combined with epidural anesthesia (EA) and general anesthesia (GA) provided pre-emptive analgesia for upper abdominal surgery. Recent studies reported that ultralow-dose naloxone enhanced the antinociceptive effect of morphine in rats. This study investigated the benefits of preincisional and postoperative epidural morphine + ropivacaine + ketamine + naloxone (M + R + K + N) treatment for achieving postoperative pain relief in upper abdominal surgery...
September 2016: Acta Anaesthesiologica Taiwanica: Official Journal of the Taiwan Society of Anesthesiologists
O Kilci, T Demir, M Günbey, C Kara, D Bayazit, D Ornek, M Baydar
PURPOSE: The aim of this study was to investigate the characteristics of the analgesic effect of diclofenac sodium injected epidurally in single or repeated doses and whether tolerance develops in long-term use. MATERIALS AND METHODS: A total of 30 rats were included in the study. The rats were anesthetized using intraperitoneal ketamine hydrochloride and an epidural catheter (EC) was inserted at the level of 13th dorsal thoraco-lumbar vertebrae (T13). Eleven rats were excluded from the study...
November 2016: Nigerian Journal of Clinical Practice
Nilesh Balu Sonawane, J Balavenkatasubramanian, P Gurumoorthi, Poonam Ashok Jadhav
No abstract text is available yet for this article.
October 2016: Indian Journal of Anaesthesia
Gloria S Cheng, Brian M Ilfeld
OBJECTIVE: To review the published evidence regarding perioperative analgesic techniques for breast cancer-related surgery. DESIGN: Topical review. METHODS: Randomized, controlled trials (RCTs) were selected for inclusion in the review. Also included were large prospective series providing estimates of potential risks and technical reports and small case series demonstrating a new technique or approaches of interest to clinicians. RESULTS: A total of 514 abstracts were reviewed, with 284 studies meeting criteria for full review...
August 22, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Vigya Goyal, Jyotsna Kubre, Krishnaprabha Radhakrishnan
CONTEXT: Postoperative pain management is becoming an integral part of anesthesia care. Various techniques of pediatric pain relief have been designed among which the most commonly practiced is caudal epidural block. Several adjuvants have been used to prolong the duration of caudal analgesia such as clonidine, neostigmine, ketamine, opioids, and ephedrine. We have designed the study using dexmedetomidine as an adjuvant to assess analgesic efficacy, duration of postoperative analgesia, hemodynamic stability, postoperative sedation, and any adverse effects in children...
May 2016: Anesthesia, Essays and Researches
Alejandra G Mora, Victoria J Ganem, Alicia T Ervin, Joseph K Maddry, Vikhyat S Bebarta
INTRODUCTION: U.S. Critical Care Air Transport Teams (CCATTs) evacuate critically ill patients with acute pain in the combat setting. Limited data have been reported on analgesic administration en route, and no study has reported analgesic use by CCATTs. Our objective was to describe analgesics used by CCATTs for nonintubated, critically ill patients during evacuation from a combat setting. METHODS: We conducted an institutional review board-approved, retrospective review of CCATT records...
May 2016: Military Medicine
Scott T Benken, Alexandra Goncharenko
This report describes a patient case utilizing a nontraditional sedative, continuous infusion ketamine, as an alternative agent for intensive care unit (ICU) sedation. A 27-year-old female presented for neurosurgical management of a coup contrecoup injury, left temporal fracture, epidural hemorrhage (EDH), and temporal contusion leading to sustained mechanical ventilation. The patient experienced profound agitation during mechanical ventilation and developed adverse effects with all traditional sedatives: benzodiazepines, dexmedetomidine, opioids, and propofol...
May 2, 2016: Journal of Pharmacy Practice
A Schulze, C Tran, V Levandovskiy, V Patel, M A Cortez
Deficiency of guanidinoacetate methyltransferase (GAMT) causes creatine depletion and guanidinoacetate accumulation in brain with the latter deemed to be responsible for the severe seizure disorder seen in affected patients. We studied electrical brain activity and GABAA mediated mechanisms of B6J.Cg-Gamt(tm1Isb) mice. Electrocorticographic (ECoG) monitoring of pharmacological treatments with ornithine (5 % in drinking water for 5-18 days) and/or Picrotoxin (PTX) (a GABAA receptor antagonist) (1.5 mg/kg, I...
August 2016: Amino Acids
Hugh D de Pereira Cardoso, Natalie C Fim, Mariangela A Marques, Helio Mint, Vania M de Vasconcelos Machado, Daneshvari R Solanki, Rodrigo Moreira Lima, Ana L de Carvalho, Lais H Navarro, Eliana M Ganem
BACKGROUND: There is experimental evidence that dexmedetomidine has neuroprotective effects. So, it could be expected that its intrathecal or epidural administration presents no harm. However, whether dexmedetomidine is neurotoxic to the spinal cord remains to be fully elucidated. OBJECTIVE: To evaluate the effect of preservative-free dexmedetomidine administered as a subarachnoid single injection on the spinal cord and meninges of rabbits. STUDY DESIGN: Research article...
February 2016: Pain Physician
Pedro Boscan, Sara Wennogle
This is a retrospective study evaluating femoral-sciatic nerve blocks (FSBs), epidural analgesia, and non-regional analgesia (NRA) in dogs undergoing tibia-plateau-leveling-osteotomy surgery. Thirty-five records met the criteria for each of the FSB and epidural analgesia groups. Seventeen anesthesia records met the criteria for the NRA or control group. The parameters reported were: isoflurane vaporizer setting, rescue analgesia/anesthesia drugs received, heart rate, systolic blood pressure, and recovery quality (0-4, with 0 being poor and 4 being good)...
March 2016: Journal of the American Animal Hospital Association
Mahin Seyedhejazi, Majed Mashhoori, Rasoul Azarfarin, Daryoush Shekhzadeh, Nasrin Taghizadieh
BACKGROUND: The aim of the present study is to compare the success rate and complications of caudal epidural bupivacaine alone or in combination with intravenous (IV) midazolam and ketamine in awake infants undergoing lower abdominal surgery. MATERIALS AND METHODS: In this double-blind, clinical trial study, 90 infants (aged below 3 months and weight below 5 kg) with American Society of Anaesthesiologists I-II, were divided into three groups of each 30: Group 1 received bupivacaine 0...
October 2015: African Journal of Paediatric Surgery: AJPS
Brian M Radvansky, Khushbu Shah, Anant Parikh, Anthony N Sifonios, Vanny Le, Jean D Eloy
OBJECTIVES: The objective of this narrative review was to examine the usage of ketamine as a postoperative analgesic agent across a wide variety of surgeries. DESIGN: A literature search was performed using the phrases "ketamine" and "postoperative pain." The authors analyzed the studies that involved testing ketamine's effectiveness at controlling postoperative pain. Effectiveness was assessed through various outcomes such as the amount of opiate consumption, visual analog scale (VAS) pain scores, and persistent postoperative pain at long-term follow-up...
2015: BioMed Research International
Philippe Richebé, Marco Julien, Véronique Brulotte
PURPOSE: This manuscript proposes pharmacological strategies that might decrease persistent postsurgical pain (PPSP). These recommendations are based on a review of current publications available in the literature. PRINCIPAL FINDINGS: Persistent postsurgical pain has been defined by the International Association for the Study of Pain as clinical discomfort that lasts more than two months after surgery. Recent reviews reported that 10-50% of patients develop chronic pain after surgery, 2-10% with disabling chronic pain at six months...
December 2015: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Waleed S H Farrag, Abdelrady S Ibrahim, Mostafa Galal Mostafa, Adel Kurkar, Ahmad A Elderwy
INTRODUCTION: Possible approaches for postoperative analgesia after pediatric inguinoscrotal surgery are caudal block by bupivacaine/ketamine (BK) and bupivacaine/magnesium sulfate (BM). AIM: The purpose of the following study is to compare the analgesic efficacy and safety of ketamine and magnesium sulfate in combination with bupivacaine for caudal blockade in pediatric patients after inguinoscrotal operations. MATERIALS AND METHODS: Patients randomly received one of the two solutions for caudal epidural injection after induction of general anesthesia...
July 2015: Urology Annals
Carl Ekstrand, Marie Sterning, Love Bohman, Anna Edner
BACKGROUND: In Sweden, scrotal or inguinal herniorrhaphy of livestock pigs in the field has traditionally been an important part of the surgical skills training of veterinary students. Few substances meet the legal requirements for field anaesthesia of production animals in the European Union but a protocol based on azaperone-detomidine-butorphanol-ketamine does. Unfortunately the anaesthesia is characterised by unpredictable duration and depth and of abrupt awakenings which is not acceptable from an animal welfare perspective and impedes surgical training...
June 24, 2015: Acta Veterinaria Scandinavica
Alfonso Fiorelli, Antonio Mazzella, Beatrice Passavanti, Pasquale Sansone, Paolo Chiodini, Mario Iannotti, Caterina Aurilio, Mario Santini, Maria Caterina Pace
OBJECTIVES: To evaluate if the pre-emptive administration of ketamine would potentiate the effect of intravenous morphine analgesia in the management of post-thoracotomy pain. METHODS: This was a unicentre, double-blind, placebo-controlled, parallel-group, prospective study. Patients were randomly assigned to receive 1 mg/kg ketamine (ketamine group) or an equivalent dose of normal saline (placebo group) before thoracotomy in 1:1 ratio. All patients received postoperatively intravenous morphine administration as additional analgesic regimen...
September 2015: Interactive Cardiovascular and Thoracic Surgery
Erin Wendt-Hornickle, Lindsey B C Snyder
OBJECTIVE: To evaluate and compare the time to extubation in two commonly used methods of analgesia in dogs undergoing elective pelvic limb orthopedic procedures. STUDY DESIGN: Prospective, randomized, double-blinded clinical study. ANIMALS: Twenty-five adult, client-owned, healthy dogs aged 4.4 ± 1.6 years and weighing 38.5 ±3.5 kg. METHODS: All dogs were premedicated with dexmedetomidine (5-10 μg kg(-1)) intramuscularly (IM) and anesthesia was induced with propofol (2-6 mg kg(-1)) intravenously (IV)...
January 2016: Veterinary Anaesthesia and Analgesia
Steven B Porter, Robert L McClain, Bonnie L Howe, Albert E Ardon, Laura S Mazer, Brittany M Knestrick, Anna M Clendenen
Many common elective surgeries are associated with moderate-to-severe postoperative pain. These common surgeries include total knee and total hip arthroplasty, thoracotomy, and multilevel lumbar spine surgery. Unfortunately, many patients requiring these surgeries are already in moderate-to-severe pain, necessitating high doses of oral or transdermal opioids preoperatively. This is an established risk factor for difficult-to-control postoperative pain.(1,2) Opioid-sparing interventions are important elements in these patients to promote convalescence and reduce common opioid side effects such as constipation, confusion, pruritus, nausea, vomiting, and urinary retention...
June 2015: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
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