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intranasal ketamine

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https://www.readbyqxmd.com/read/27890484/25-years-of-advances-in-definition-classification-and-treatment-of-status-epilepticus
#1
Eugen Trinka, Reetta Kälviäinen
PURPOSE: Status epilepticus (SE) requires not only urgent symptomatic treatment with antiepileptic drugs but also rapid identification and treatment of its cause. This narrative review summarizes the most important advances in classification and treatment of SE. METHOD: Data sources included MEDLINE, EMBASE, ClinicalTrials.gov, and back tracking of references in pertinent studies, reviews, and books. RESULTS: SE is now defined as "a condition resulting either from the failure of the mechanisms responsible for seizure termination or from the initiation of mechanisms, which lead to abnormally, prolonged seizures (after time point t1)...
November 14, 2016: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/27886522/increase-in-pas-induced-neuroplasticity-after-a-treatment-course-of-intranasal-ketamine-for-depression-report-of-three-cases-from-a-placebo-controlled-trial
#2
Verònica Gálvez, Stevan Nikolin, Kerrie-Anne Ho, Angelo Alonzo, Andrew A Somogyi, Colleen K Loo
BACKGROUND: Animal studies suggest that neural plasticity may play a role in the antidepressant effects of a single ketamine dose. However, the potential effects of repeated ketamine treatments on human neuroplasticity are unknown. METHODS: This pilot RCT study measured plasticity-induced changes before and after a ketamine course, in three treatment-resistant depressed subjects, who were randomized to receive 8 intranasal treatments of 100mg ketamine or 4.5mg midazolam...
November 4, 2016: Comprehensive Psychiatry
https://www.readbyqxmd.com/read/27829367/intranasal-ketamine-for-acute-traumatic-pain-in-the-emergency-department-a-prospective-randomized-clinical-trial-of-efficacy-and-safety
#3
Shachar Shimonovich, Roy Gigi, Amir Shapira, Tal Sarig-Meth, Danielle Nadav, Mattan Rozenek, Debra West, Pinchas Halpern
BACKGROUND: Ketamine has been well studied for its efficacy as an analgesic agent. However, intranasal (IN) administration of ketamine has only recently been studied in the emergency setting. The objective of this study was to elucidate the efficacy and adverse effects of a sub-dissociative dose of IN Ketamine compared to IV and IM morphine. METHODS: A single-center, randomized, prospective, parallel clinical trial of efficacy and safety of IN ketamine compared to IV and IM morphine for analgesia in the emergency department (ED)...
November 9, 2016: BMC Emergency Medicine
https://www.readbyqxmd.com/read/27734549/comparison-of-oral-midazolam-with-intranasal-dexmedetomidine-premedication-for-children-undergoing-ct-imaging-a-randomized-double-blind-and-controlled-study
#4
Babita Ghai, Kajal Jain, Akshay Kumar Saxena, Nidhi Bhatia, Kushaljit Singh Sodhi
BACKGROUND: Children undergoing computerized tomography (CT) frequently require sedation to allay their anxiety, and prevent motion artifacts and stress of intravenous (IV) cannulation. AIMS: The aim of this trial was to compare the effectiveness of oral midazolam and intranasal dexmedetomidine as sole premedicants in children for carrying out both IV cannulation as well as CT scanning, without the need for additional IV sedatives. METHODS: Fifty-nine children, aged 1-6 years, scheduled to undergo CT imaging under sedation were randomized to receive either 0...
October 13, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27609854/study-protocol-of-a-randomised-controlled-trial-of-intranasal-ketamine-compared-with-intranasal-fentanyl-for-analgesia-in-children-with-suspected-isolated-extremity-fractures-in-the-paediatric-emergency-department
#5
Stacy L Reynolds, Jonathan R Studnek, Kathleen Bryant, Kelly VanderHave, Eric Grossman, Charity G Moore, James Young, Melanie Hogg, Michael S Runyon
INTRODUCTION: Fentanyl is the most widely studied intranasal (IN) analgesic in children. IN subdissociative (INSD) ketamine may offer a safe and efficacious alternative to IN fentanyl and may decrease overall opioid use during the emergency department (ED) stay. This study examines the feasibility of a larger, multicentre clinical trial comparing the safety and efficacy of INSD ketamine to IN fentanyl and the potential role for INSD ketamine in reducing total opioid medication usage. METHODS AND ANALYSIS: This double-blind, randomised controlled, pilot trial will compare INSD ketamine (1 mg/kg) to IN fentanyl (1...
September 8, 2016: BMJ Open
https://www.readbyqxmd.com/read/27570849/intranasal-sedatives-in-pediatric-dentistry
#6
Maha A AlSarheed
OBJECTIVES: To identify the intranasal (IN) sedatives used to achieve conscious sedation during dental procedures amongst children. METHODS: A literature review was conducted by identifying relevant studies through searches on Medline. Search included IN of midazolam, ketamine, sufentanil, dexmedetomidine, clonidine, haloperidol, and loranzepam. Studies included were conducted amongst individuals below 18 years, published in English, and were not restricted by year...
September 2016: Saudi Medical Journal
https://www.readbyqxmd.com/read/27560521/increased-plasma-matrix-metalloproteinase-9-levels-contribute-to-intracerebral-hemorrhage-during-thrombolysis-after-concomitant-stroke-and-influenza-infection
#7
Sajjad Muhammad, Oliver Planz, Markus Schwaninger
BACKGROUND: Thrombolysis is the only approved therapy for acute stroke. However, life-threatening complications such as intracerebral hemorrhage (ICH) can develop after intravenous administration of tissue plasminogen activator (tPA). Both infection and thrombolysis during cerebral ischemia disrupt the blood-brain barrier (BBB). tPA can induce matrix metalloproteinase-9 (MMP-9), which is known to be involved in BBB disruption. However, it has still not been investigated whether preexisting influenza virus infection during thrombolysis after acute stroke affects systemic levels of MMP-9 and its inhibitor TIMP-1 and whether increased systemic MMP-9 levels affect ICH...
2016: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/27513257/the-effect-of-addition-of-ketamine-to-lidocaine-on-postoperative-pain-in-rhinoplasties
#8
Mukadder Şanli, Nurçin Gülhaş, Bilge Türk Bilen, Gülay Erdoğan Kayhan, Muharrem Uçar, Ahmet Hamdi Aytekin, Saim Yoloğlu
BACKGROUND/AIM: The objective of this study was to examine the effect of addition of subanesthetic doses of ketamine to an epinephrine-lidocaine solution on postoperative pain, analgesic use, and patient comfort during rhinoplasties. MATERIALS AND METHODS: Ninety patients were randomly divided into three groups: Group L, lidocaine with epinephrine; Group K, lidocaine with epinephrine plus ketamine; and Group S (control group), physiological saline solution with epinephrine...
2016: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/27475684/current-methods-of-sedation-in-dental-patients-a-systematic-review-of-the-literature
#9
J-R Corcuera-Flores, J Silvestre-Rangil, A Cutando-Soriano, J López-Jiménez
OBJECTIVE: The main objective of this systematic literature review is to identify the safest and most effective sedative drugs so as to ensure successful sedation with as few complications as possible. STUDY DESIGN: A systematic literature review of the PubMed MEDLINE database was carried out using the key words "conscious sedation," "drugs," and "dentistry." A total of 1,827 scientific articles were found, and these were narrowed down to 473 articles after applying inclusion and exclusion criteria...
September 1, 2016: Medicina Oral, Patología Oral y Cirugía Bucal
https://www.readbyqxmd.com/read/27374385/clinical-evaluation-of-intranasal-medetomidine-ketamine-and-medetomidine-s-ketamine-for-induction-of-anaesthesia-in-rabbits-in-two-centres-with-two-different-administration-techniques
#10
Linda C Weiland, Katharina Kluge, Annette Pn Kutter, Peter W Kronen
OBJECTIVE: The aim was to compare efficacy and side effects of induction with medetomidine-ketamine or medetomidine-S(+)-ketamine by intranasal (IN) instillation in rabbits and to evaluate both protocols during subsequent isoflurane anaesthesia. STUDY DESIGN: Prospective, blinded, randomized experimental study in two centres. ANIMALS: Eighty-three healthy New Zealand White rabbits undergoing tibial or ulnar osteotomy. METHODS: Medetomidine (0...
July 4, 2016: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/27307665/comparative-evaluation-of-dexmedetomidine-and-midazolam-ketamine-combination-as-sedative-agents-in-pediatric-dentistry-a-double-blinded-randomized-controlled-trial
#11
Parul Uppal Malhotra, Seema Thakur, Parul Singhal, Deepak Chauhan, Cheranjeevi Jayam, Ritu Sood, Yagyeshwar Malhotra
BACKGROUND: Pharmacological methods have been used as an adjunct to enhance child cooperativeness and facilitate dental treatment. OBJECTIVE: Purpose of this study was to evaluate and compare the effect of sedation by intranasal dexmedetomidine and oral combination drug midazolam-ketamine in a group of children with uncooperative behavior requiring dental treatment. MATERIALS AND METHODS: This was a prospective, randomized, double-blind study that included patients 3-9 years old with American Society of Anesthesiologists-I status...
April 2016: Contemporary Clinical Dentistry
https://www.readbyqxmd.com/read/27212773/comparison-of-intranasal-dexmedetomidine-and-dexmedetomidine-ketamine-for-premedication-in-pediatrics-patients-a-randomized-double-blind-study
#12
Ravi Bhat, M C B Santhosh, Venkatesh M Annigeri, Raghavendra P Rao
BACKGROUND: Goal of premedication in pediatric anesthesia are relieving pre and postoperative anxiety, good parental separation, and smooth induction of anesthesia. Anxiety can produce aggressive reactions, increased distress, increased postoperative pain and postoperative agitation. The benzodiazepine, midazolam, is the most frequently used premedication in pediatric anesthesia. Midazolam has a number of beneficial effects when used as premedication in children: Sedation, fast onset, and limited duration of action...
May 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27198122/midazolam-for-sedation-before-procedures
#13
REVIEW
Aaron Conway, John Rolley, Joanna R Sutherland
BACKGROUND: Midazolam is used for sedation before diagnostic and therapeutic medical procedures. It is an imidazole benzodiazepine that has depressant effects on the central nervous system (CNS) with rapid onset of action and few adverse effects. The drug can be administered by several routes including oral, intravenous, intranasal and intramuscular. OBJECTIVES: To determine the evidence on the effectiveness of midazolam for sedation when administered before a procedure (diagnostic or therapeutic)...
May 20, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27175895/intranasal-ketamine-in-subdissociative-doses-for-a-2-year-old
#14
Billy Sin, Timothy Nguyen, Serena Chew, Erica Caffarini, Upulie Nawaratne, Noah Kondamudi
No abstract text is available yet for this article.
May 12, 2016: American Journal of Therapeutics
https://www.readbyqxmd.com/read/27062450/ketamine-for-treatment-resistant-unipolar-and-bipolar-major-depression-critical-review-and-implications-for-clinical-practice
#15
REVIEW
William V Bobo, Jennifer L Vande Voort, Paul E Croarkin, Jonathan G Leung, Susannah J Tye, Mark A Frye
There is an urgent need for more rapidly effective pharmacotherapies for major depressive disorder and bipolar disorder (BP) that are efficacious and tolerable for depressed patients who respond poorly to conventional treatments. Multiple controlled trials have now demonstrated a rapid, nonsustained antidepressive response to a single intravenous infusion of ketamine. Early controlled studies of intranasal or serial infusion therapy appear promising. The effective dose for depression is lower than the typical anesthetic doses, and side-effects are generally mild and transient...
August 2016: Depression and Anxiety
https://www.readbyqxmd.com/read/27006733/intranasal-ketamine-for-the-treatment-of-patients-with-acute-pain-in-the-emergency-department
#16
Roshana Shrestha, Samita Pant, Ashis Shrestha, Kabita Hada Batajoo, Rashmi Thapa, Sumana Vaidya
BACKGROUND: Pain in the emergency department (ED) is common but undertreated. The objective of this study was to examine the efficacy and safety of intranasal (IN) ketamine used as an analgesic for patients with acute injury with moderate to severe pain. METHODS: This study was a cross sectional, observational study of patients more than 8 years old experiencing moderate to severe pain [visual analog score (VAS) >50 mm]. The initial dose of IN ketamine was 0...
2016: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/26926332/update-on-pharmacological-management-of-procedural-sedation-for-children
#17
Mark G Roback, Douglas W Carlson, Franz E Babl, Robert M Kennedy
PURPOSE OF REVIEW: The review provides an update on pharmacological techniques for procedural sedation for children outside the operating room. RECENT FINDINGS: An increasing number of studies of propofol, ketamine, nitrous oxide, dexmedetomidine, and intranasal administration of drugs for procedural sedation of children continue to be reported. SUMMARY: Propofol and ketamine are commonly used for procedural sedation in children and the use of dexmedetomidine and nitrous oxide is increasing...
March 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/26834167/oral-ketamine-for-the-treatment-of-pain-and-treatment-resistant-depression%C3%A2
#18
REVIEW
Robert A Schoevers, Tharcila V Chaves, Sonya M Balukova, Marije Aan Het Rot, Rudie Kortekaas
BACKGROUND: Recent studies with intravenous (i.v.) application of ketamine show remarkable but short-term success in patients with MDD. Studies in patients with chronic pain have used different ketamine applications for longer time periods. This experience may be relevant for psychiatric indications. AIMS: To review the literature about the dosing regimen, duration, effects and side-effects of oral, intravenous, intranasal and subcutaneous routes of administration of ketamine for treatment-resistant depression and pain...
February 2016: British Journal of Psychiatry: the Journal of Mental Science
https://www.readbyqxmd.com/read/26766932/non-intravenous-sedatives-and-analgesics-for-procedural-sedation-for-imaging-procedures-in-pediatric-patients
#19
REVIEW
Amber Thomas, Jamie L Miller, Kevin Couloures, Peter N Johnson
OBJECTIVES: The purpose of this study was to describe the method of delivery, dosage regimens, and outcomes of sedatives administered by extravascular route for imaging procedures in children. METHODS: Medline, Embase, International Pharmaceutical Abstracts, and Cochrane Database of Systematic Reviews were searched using keywords "child", "midazolam", "ketamine", dexmedetomidine", "fentanyl", "nitrous oxide", and "imaging." Articles evaluating the use of extravascular sedation in children for imaging procedures published in English between 1946 and March 2015 were included...
November 2015: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/26752601/strategies-to-mitigate-dissociative-and-psychotomimetic-effects-of-ketamine-in-the-treatment-of-major-depressive-episodes-a-narrative-review
#20
Matthew D Cooper, Joshua D Rosenblat, Danielle S Cha, Yena Lee, Ron Kakar, Roger S McIntyre
Objectives Replicated evidence has demonstrated that ketamine exerts rapid-acting and potent antidepressant effects. Notwithstanding, its promise to mitigate depressive symptoms and suicidality in antidepressant-resistant populations, several limitations and safety concerns accompany ketamine including, but not limited to, the potential for abuse and psychotomimetic/dissociative experiences. The focus of the current narrative review is to synthesise available evidence of strategies that may mitigate and fully prevent treatment-emergent psychotomimetic and dissociative effects associated with ketamine administration...
March 16, 2016: World Journal of Biological Psychiatry
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