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21. [Remifentanil-ketamine vs. propofol-ketamine for sedation in pediatric patients undergoing colonoscopy: A randomized clinical trial]. (PubMed)

[Remifentanil-ketamine vs. propofol-ketamine for sedation in pediatric patients undergoing colonoscopy: A randomized clinical trial]. Pediatric patients frequently require deep sedation or general anesthesia for colonoscopy. This study was designed to compare the sedative efficacy of remifentanil-ketamine combination with propofol-ketamine combination in children undergoing colonoscopy.Seventy patients, between 2 and 16 years of age, scheduled for diagnostic colonoscopy were randomly allocated (...) into two groups. Remifentanil-ketamine group received intravenous ketamine 2mg.kg-1 and remifentanil 0.25μg.kg-1 combination, followed by 0.1μg.kg-1.min-1 remifentanil infusion. Propofol-ketamine group received intravenous propofol 1 and 2mg.kg-1 ketamine combination, followed by 1mg.kg-1.h-1 propofol infusion. In the case of children discomfort (cry, movement, and cough), remifentanil 0.1μg.kg-1 in the remifentanil-ketamine group or propofol 0.5mg.kg-1 in the propofol-ketamine group were administered

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2019 Revista brasileira de anestesiologia Controlled trial quality: uncertain

22. Efficacy of Adding Low-Dose Ketamine to Dexmedetomidine Versus Low-Dose Ketamine and Propofol for Conscious Sedation in Patients Undergoing Awake Fiber-optic Intubation. (PubMed)

Efficacy of Adding Low-Dose Ketamine to Dexmedetomidine Versus Low-Dose Ketamine and Propofol for Conscious Sedation in Patients Undergoing Awake Fiber-optic Intubation. Conscious sedation is the key for successful AFOI. This trial was conducted to compare the effectiveness of dexmedetomidine and low dose of ketamine against propofol and low dose ketamine.Sixty patients subjected for general anesthesia were invited to participate in the study and randomly allocated into two equal groups: D-K (n (...) = 30) had been received a bolus dose of both ketamine 0.5mg /kg and dexmedetomidine 1ug/kg over 10 min. Then continuous infusion of ketamine 0.5mg /kg and dexmedetomidine 1ug/kg. The second group (P-K group) (n = 30): had been received a bolus dose of both ketamine 0.5mg/kg and propofol 1mg/kg over 10 min. Then continuous infusion of ketamine 0. 5mg/kg and propofol 1mg/kg.The intubation time was statistically significant shorter within the D-K group (58.9 ± 6.1) versus P-K group (63.4 ± 5.3) with p

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2019 Anesthesia, essays and researches Controlled trial quality: uncertain

23. Neurocognitive performance under combined regimens of ketamine-dexmedetomidine and ketamine-fentanyl in healthy adults: A randomised trial. (PubMed)

Neurocognitive performance under combined regimens of ketamine-dexmedetomidine and ketamine-fentanyl in healthy adults: A randomised trial. Analgesic doses of ketamine affects neurocognition; however, deficits under co-administration regimens are unknown. This study evaluated the effects of ketamine, alone and in combination with dexmedetomidine or fentanyl on neurocognition. Using a randomised, within-subjects gender stratified design, 39 participants (mean age = 28.4, SD ± 5.8) received (...) a ketamine bolus of 0.3 mg/kg followed by 0.15 mg/kg/h infusion of ketamine (3 h duration). At 1.5 h post-ketamine infusion commencement, participants received either: i) 0.7 μg/kg/h infusion of dexmedetomidine (n = 19) (KET/DEX) or (ii) three 25 μg fentanyl injections over 1.5 h (n = 20) (KET/FENT). Reaction and Movement time (RTI, Simple and 5Choice), Visuospatial Working Memory (SWM) and Verbal Recognition Memory (VRM) were assessed using the Cambridge Neuropsychological Test Automated Battery (CANTAB

2019 Progress in neuro-psychopharmacology & biological psychiatry Controlled trial quality: uncertain

24. Comparison of Ketamine-Propofol and Ketamine-Thiopental on Bispectral Index Values during Monitored Anesthesia Care (MAC) in Minor Traumatic Orthopedic Surgery; A Randomized, Double-Blind, Clinical Trial. (PubMed)

Comparison of Ketamine-Propofol and Ketamine-Thiopental on Bispectral Index Values during Monitored Anesthesia Care (MAC) in Minor Traumatic Orthopedic Surgery; A Randomized, Double-Blind, Clinical Trial. To compare the effects of ketamine-propofol and ketamine-thiopental on bispectral index values during monitored anesthesia care in minor orthopedic surgeries.This randomized double-blind clinical trial was performed on 90 patients undergoing minor orthopedic surgeries. Participants were (...) randomly allocated to either groups of propofol or thiopental. Bispectral index (BIS), non-invasive arterial blood pressure, SpO2, and electrocardiogram were monitored every 5 minutes. Patients in propofol group received a bolus dose of 0.5 mg/kg ketamine, plus 0.5 mg/kg propofol. In thiopental group, patients received a bolus dose of 0.5 mg/kg ketamine, plus 50-75 mg thiopental. After the surgery, recovery duration, patients' pain score (VAS) and any intra-operative recall or awareness were recorded

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2019 Bulletin of emergency and trauma Controlled trial quality: uncertain

25. A meta-analysis of randomized controlled trials: combination of ketamine and propofol versus ketamine alone for procedural sedation and analgesia in children. (PubMed)

A meta-analysis of randomized controlled trials: combination of ketamine and propofol versus ketamine alone for procedural sedation and analgesia in children. Although ketamine has been used for procedural sedation and analgesia, some researchers have assessed ketamine-propofol as a better alternative because of its reduced adverse events. The goal of this review was to compare adverse events between ketamine-propofol and ketamine for procedural sedation and analgesia in children. We searched (...) the literature from their inception to May 2018 without the restriction of language. We included all randomized controlled trials comparing ketamine-propofol with ketamine for procedural sedation and analgesia in children. The meta-analysis was conducted using the Stata software. A total of six studies involving 693 individuals were included. Pooling of data showed that subjects with ketamine-propofol had similar incidence of respiratory adverse events compared to those with ketamine (RR 1.16, 95% CI 0.68

2019 Internal and emergency medicine

26. Effects of ketamine treatment on suicidal ideation: a qualitative study of patients' accounts following treatment for depression in a UK ketamine clinic. (PubMed)

Effects of ketamine treatment on suicidal ideation: a qualitative study of patients' accounts following treatment for depression in a UK ketamine clinic. It is recognised that ketamine treatment can reduce suicidal ideation (SI) in people with depression, at least in the short term. However, information is lacking on patients' perspectives on such effects. Studying these can contribute to greater understanding of the mechanisms underlying impact of ketamine treatment on SI. The aim (...) of this study was to investigate patients' reports of the impact of treatment on their SI, the duration of effects and possible mechanisms.This qualitative study consisted of semi-structured interviews with patients who had received ketamine treatment for depression. Interview data were analysed thematically.Fourteen patients (8 females, 6 males, aged 24-64 years) who had received treatment with ketamine for treatment-resistant depression, and had SI at the initiation of treatment. Two participants also had

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2019 BMJ open

27. Ketamine infusion for treatment-resistant bipolar depression

Ketamine infusion for treatment-resistant bipolar depression Ketamine infusion for treatment-resistant bipolar depression Ketamine infusion for treatment-resistant bipolar depression HAYES, Inc Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation HAYES, Inc. Ketamine infusion for treatment-resistant bipolar depression. Lansdale: HAYES, Inc. Healthcare Technology (...) Brief Publication. 2017 Authors' conclusions Health Problem: Bipolar disorder is a chronic illness characterized by alternating periods of profound depression and excessively elevated or irritable mood (mania). These episodes of extreme mood are interspersed by periods of relatively normal mood. Bipolar disorder is a severely impairing illness associated with unemployment, decreased productivity, and excess mortality. Technology Description: Ketamine therapy for bipolar disorder often involves

2017 Health Technology Assessment (HTA) Database.

28. Ketamine as primary therapy for treatment-resistant unipolar depression or posttraumatic stress disorder

Ketamine as primary therapy for treatment-resistant unipolar depression or posttraumatic stress disorder Ketamine as primary therapy for treatment-resistant unipolar depression or posttraumatic stress disorder Ketamine as primary therapy for treatment-resistant unipolar depression or posttraumatic stress disorder HAYES, Inc Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database (...) . Citation HAYES, Inc. Ketamine as primary therapy for treatment-resistant unipolar depression or posttraumatic stress disorder. Lansdale: HAYES, Inc. Directory Publication. 2017 Authors' conclusions Health Problem: Treatment-resistant depression (TRD) is typically defined as depression that does not respond to at least 2 attempts at treatment of adequate duration with appropriate doses of antidepressants, but there is no official consensus definition. Posttraumatic stress disorder (PTSD) is an anxiety

2017 Health Technology Assessment (HTA) Database.

29. Ketamine as an adjunct to electroconvulsive therapy for treatment-resistant depression

Ketamine as an adjunct to electroconvulsive therapy for treatment-resistant depression Ketamine as an adjunct to electroconvulsive therapy for treatment-resistant depression Ketamine as an adjunct to electroconvulsive therapy for treatment-resistant depression HAYES, Inc Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation HAYES, Inc. Ketamine as an adjunct (...) Description: Intravenous injection (IV) of ketamine hydrochloride as an adjunct to electroconvulsive therapy (ECT) is intended to reduce symptoms of depression more rapidly and to a greater extent than ECT alone in patients who have TRD. Controversy: Early evidence for the antidepressant effect of ketamine came from uncontrolled studies and TRD may have diverse causes and poor response rates that make it difficult to demonstrate whether or not ketamine treatment is effective. Key Questions: Does ketamine

2017 Health Technology Assessment (HTA) Database.

30. Serum concentration of ketamine and antinociceptive effects of ketamine and ketamine-lidocaine infusions in conscious dogs. (PubMed)

Serum concentration of ketamine and antinociceptive effects of ketamine and ketamine-lidocaine infusions in conscious dogs. Central sensitization is a potential severe consequence of invasive surgical procedures. It results in postoperative and potentially chronic pain enhancement. It results in postoperative pain enhancement; clinically manifested as hyperalgesia and allodynia. N-methyl-D-aspartate (NMDA) receptor plays a crucial role in the mechanism of central sensitisation. Ketamine is most (...) commonly used NMDA-antagonist in human and veterinary practice. However, the antinociceptive serum concentration of ketamine is not yet properly established in dogs. Six dogs were used in a crossover design, with one week washout period. Treatments consisted of: 1) 0.5 mg/kg ketamine followed by continuous rate infusion (CRI) of 30 μg/kg/min; 2) 0.5 mg/kg ketamine followed by CRI of 30 μg/kg/min and lidocaine (2 mg/kg followed by CRI of 100 μg/kg/min); and 3) 0.5 mg/kg ketamine followed by CRI of 50 μg

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2017 BMC veterinary research Controlled trial quality: uncertain

31. Early Administration of Ketamine in Refractory Status Epilepticus

Early Administration of Ketamine in Refractory Status Epilepticus "Early Administration of Ketamine in Refractory Status Epilepticus" by Kayla Moody < > > > > > Title Author Date of Graduation Summer 8-11-2018 Degree Type Capstone Project Degree Name Master of Science in Physician Assistant Studies Rights . Abstract Purpose: While protocols regarding how to treat status epilepticus (SE) has been universally accepted, management of refractory status epilepticus (RSE) is far from being evidence (...) -based. Ketamine (KET), a NMDA-antagonist, may have a role in RSE when other conventional anesthetics fail due to its unique pharmacodynamic properties and good safety profile. Methods: Exhaustive search of available medical literature was performed using MEDLINE-Ovid, MEDLINE-PubMed, Psych INFO, Web of Science, and CINAHL for relevant articles from 2012-2017 using keywords “ketamine” and “status epilepticus.” Additional criteria for consideration: articles applicable to the topic and published

2018 Pacific University EBM Capstone Project

32. Low-dose Ketamine for Acute Pain in the Emergency Department

Low-dose Ketamine for Acute Pain in the Emergency Department BestBets: Low-dose Ketamine for Acute Pain in the Emergency Department Low-dose Ketamine for Acute Pain in the Emergency Department Report By: Colby Duncan MD - Senior EM Resident Search checked by Brad Riley MD - EM Faculty Institution: Grand Rapids Medical Education Research Partners/Michigan State University Date Submitted: 15th July 2016 Date Completed: 11th February 2017 Last Modified: 11th February 2017 Status: Green (complete (...) ) Three Part Question [In ED patients with acute pain who do not respond to conventional therapies], is the [low-dose ketamine better than morphine] at [safely and effectively reducing pain scores]? Clinical Scenario A man aged 25 years presents to the ED with a closed fracture of the right humeral head. He has severe pain around the shoulder and is allergic to opioids. He is given intravenous ketorolac and midazolam. Unfortunately, the patient's pain does not improve. A colleague recommends the use

2017 BestBETS

33. Clinical evaluation of intranasal medetomidine-ketamine and medetomidine-S(+)-ketamine for induction of anaesthesia in rabbits in two centres with two different administration techniques. (PubMed)

Clinical evaluation of intranasal medetomidine-ketamine and medetomidine-S(+)-ketamine for induction of anaesthesia in rabbits in two centres with two different administration techniques. 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.Prospective, blinded, randomized experimental study in two centres.Eighty (...) -three healthy New Zealand White rabbits undergoing tibial or ulnar osteotomy.Medetomidine (0.2 mg kg-1) with 10 mg kg-1 ketamine (MK) or 5 mg kg-1 S(+)-ketamine (MS) was administered IN to each rabbit in a randomized fashion. In Centre 1 (n = 42) rabbits were held in sternal recumbency, and in Centre 2 (n = 41) in dorsal recumbency, during drug instillation. Adverse reactions were recorded. If a rabbit swallowed during endotracheal intubation, half of the initial IN dose was repeated and intubation

2018 Veterinary anaesthesia and analgesia Controlled trial quality: uncertain

34. Comparison of dexmedetomidine and ketamine versus propofol and ketamine for procedural sedation in children undergoing minor cardiac procedures in cardiac catheterization laboratory. (PubMed)

Comparison of dexmedetomidine and ketamine versus propofol and ketamine for procedural sedation in children undergoing minor cardiac procedures in cardiac catheterization laboratory. The ideal anaesthetic technique for management of paediatric patients scheduled to undergo cardiac catheterisation is still not standardised.To compare the effects of ketamine-propofol and ketamine-dexmedetomidine combinations on hemodynamic parameters and recovery time in paediatric patients undergoing minor (...) procedures and cardiac catheterisation under sedation for various congenital heart diseases.60 children of either sex undergoing cardiac catheterisation were randomly assigned into two groups Dexmedetomidine-ketamine group (DK) and Propofol-ketamine (PK) of 30 patients each. All patients were premedicated with glycopyrrolate and midazolam (0.05mg/kg) intravenously 5-10 min before anaesthetic induction. Group 'DK'received dexmedetomidineiv infusion 1 μg/kg over 10 min + ketamine1mg/kg bolus, followed

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2018 Annals of cardiac anaesthesia Controlled trial quality: uncertain

35. Recovery of horses from general anesthesia after induction with propofol and ketamine versus midazolam and ketamine. (PubMed)

Recovery of horses from general anesthesia after induction with propofol and ketamine versus midazolam and ketamine. OBJECTIVE To evaluate quality of recovery from general anesthesia in horses after induction with propofol and ketamine versus midazolam and ketamine. DESIGN Prospective randomized crossover study. ANIMALS 6 healthy adult horses. PROCEDURES Horses were premedicated with xylazine (1.0 mg/kg [0.45 mg/lb], IV), and general anesthesia was induced with midazolam (0.1 mg/kg [0.045 mg/lb (...) ], IV) or propofol (0.5 mg/kg [0.23 mg/lb], IV), followed by ketamine (3.0 mg/kg [1.36 mg/lb], IV). Horses were endotracheally intubated, and anesthesia was maintained with isoflurane. After 60 minutes, horses were given romifidine (0.02 mg/kg [0.009 mg/lb], IV) and allowed to recover unassisted. Times to first movement, sternal recumbency, and standing and the number of attempts to stand were recorded. Plasma concentrations of propofol or midazolam were measured following induction and immediately

2018 Journal of the American Veterinary Medical Association

36. Total intravenous anaesthesia with ketamine, medetomidine and guaifenesin compared with ketamine, medetomidine and midazolam in young horses anaesthetised for computerised tomography. (PubMed)

Total intravenous anaesthesia with ketamine, medetomidine and guaifenesin compared with ketamine, medetomidine and midazolam in young horses anaesthetised for computerised tomography. There is no information directly comparing midazolam with guaifenesin when used in combination with an alpha-2 agonist and ketamine to maintain anaesthesia via i.v. infusion in horses.To compare ketamine-medetomidine-guaifenesin with ketamine-medetomidine-midazolam for total intravenous anaesthesia (TIVA) in young (...) horses anaesthetised for computerised tomography.Prospective, randomised, blinded, crossover trial.Fourteen weanlings received medetomidine 7 μg/kg bwt i.v. and anaesthesia was induced with ketamine 2.2 mg/kg bwt i.v. On two separate occasions horses each received infusions of ketamine 3 mg/kg bwt/h, medetomidine 5 μg/kg bwt/h, guaifenesin 100 mg/kg bwt/h (KMG) or ketamine 3 mg/kg bwt/h, medetomidine 5 μg/kg bwt/h, midazolam 0.1 mg/kg bwt/h (KMM) for 50 min. Cardiorespiratory variables

2018 Equine veterinary journal Controlled trial quality: uncertain

37. Ketamine versus Ketamine / magnesium Sulfate for Procedural Sedation and Analgesia in the Emergency Department: A Randomized Clinical Trial (PubMed)

Ketamine versus Ketamine / magnesium Sulfate for Procedural Sedation and Analgesia in the Emergency Department: A Randomized Clinical Trial The present study was designed to evaluate the effectiveness of magnesium sulfate (MgSO4) in procedural sedation and analgesia (PSA) when combined with ketamine in patients with fractures in emergency departments and required short and painful emergency procedures.In this study, 100 patients with fractures and dislocations who were presented (...) to the emergency departments and required PSA for short and painful emergency procedures were randomly allocated to groups of ketamine plus MgSO4 or ketamine alone. Train of four (TOF) stimulation pattern was assessed using nerve stimulator machine and compared between groups.The mean age of studied patients was 46.9 ± 9.3 years old. 48% were male and 52% were female. No significant differences were noted between groups in demographic variables. The status of TOF, 2 min after the injection of ketamine (1.5 mg

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2018 Advanced biomedical research Controlled trial quality: uncertain

38. A Comparison of Oral Midazolam-ketamine, Dexmedetomidine-fentanyl, and Dexmedetomidine-ketamine Combinations as Sedative Agents in Pediatric Dentistry: A Triple-Blinded Randomized Controlled Trial (PubMed)

A Comparison of Oral Midazolam-ketamine, Dexmedetomidine-fentanyl, and Dexmedetomidine-ketamine Combinations as Sedative Agents in Pediatric Dentistry: A Triple-Blinded Randomized Controlled Trial It is common to encounter a patient who is anxious to the magnitude that precludes the possibility of provision of dental treatment. This study aims to evaluate and compare the sedative effect of oral combinations of midazolam-ketamine (MK), dexmedetomidine-fentanyl (DF), and dexmedetomidine-ketamine

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2018 Contemporary clinical dentistry Controlled trial quality: uncertain

39. Ketamine and Ketamine Metabolite Pharmacology: Insights into Therapeutic Mechanisms (PubMed)

Ketamine and Ketamine Metabolite Pharmacology: Insights into Therapeutic Mechanisms Ketamine, a racemic mixture consisting of (S)- and (R)-ketamine, has been in clinical use since 1970. Although best characterized for its dissociative anesthetic properties, ketamine also exerts analgesic, anti-inflammatory, and antidepressant actions. We provide a comprehensive review of these therapeutic uses, emphasizing drug dose, route of administration, and the time course of these effects. Dissociative (...) , psychotomimetic, cognitive, and peripheral side effects associated with short-term or prolonged exposure, as well as recreational ketamine use, are also discussed. We further describe ketamine's pharmacokinetics, including its rapid and extensive metabolism to norketamine, dehydronorketamine, hydroxyketamine, and hydroxynorketamine (HNK) metabolites. Whereas the anesthetic and analgesic properties of ketamine are generally attributed to direct ketamine-induced inhibition of N-methyl-D-aspartate receptors

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2018 Pharmacological reviews

40. Ketamine versus ketamine pluses atropine for pediatric sedation: A meta-analysis. (PubMed)

Ketamine versus ketamine pluses atropine for pediatric sedation: A meta-analysis. The application of atropine for pediatric sedation in the emergency department remains controversial. Our objective was to perform a comprehensive review of the literature and assess the clinical indexes in groups with and without atropine use.PubMed, EMBASE, and the Cochrane Library were searched for randomized and non-randomized studies that compared ketamine and ketamine plus atropine for pediatric sedation (...) . The risk ratio with 95% confidence interval was calculated using either a fixed- or random-effects model according to the value of I2.One retrospective study and four randomized controlled trials were identified to compare the clinical indexes. For the clinical indexes, the ketamine plus atropine group had better outcomes than the ketamine group in hypersalivation (P<0.05), but indexes of rash and tachycardia were worse. The two methods of sedation were comparable for nausea, vomiting, desaturation

2018 American Journal of Emergency Medicine

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