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Ketamine

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6141. Cognitive impairment after small-dose ketamine isomers in comparison to equianalgesic racemic ketamine in human volunteers. (Abstract)

Cognitive impairment after small-dose ketamine isomers in comparison to equianalgesic racemic ketamine in human volunteers. Ketamine is increasingly used in pain therapy but may impair brain functions. Mood and cognitive capacities were compared after equianalgesic small-dose S(+)-, R(-)-, and racemic ketamine in healthy volunteers.Twenty-four subjects received intravenous 0.5 mg/kg racemic, 0.25 mg/kg S(+)-, and 1.0 mg/kg R(-)-ketamine in a prospective, randomized, double-blind, crossover (...) study. Hemodynamic variables, mood, and cognitive capacities were assessed for 60 min.Transient increases in blood pressure, heart rate, and catecholamines were similar after administration of all drugs. At 20 min after injection, subjects felt less decline in concentration and were more brave after S(+)- than racemic ketamine. They reported being less lethargic but more out-of-control after R(-)- than racemic ketamine. Ketamine isomers induced less drowsiness, less lethargy, and less impairment

2002 Anesthesiology Controlled trial quality: uncertain

6142. The comparison of caudal ketamine, alfentanil and ketamine plus alfentanil administration for postoperative analgesia in children. (Abstract)

The comparison of caudal ketamine, alfentanil and ketamine plus alfentanil administration for postoperative analgesia in children. Our aim was to compare the effect of single dose caudal ketamine, alfentanil or a mixture of both drugs in the treatment of pain after hypospadias repair surgery in children.The group comprised 109 boys, ASA I-II, aged 1-9 years, who were undergoing hypospadias repair surgery as day cases. The children were randomly divided into three groups for postoperative (...) analgesia: group 1, only alfentanil (20 microg x kg(-10) was given caudally; group 2, ketamine (0.5 mg x kg(-1)) alone; and group 3, alfentanil (20 microg x kg(-1))-ketamine (0.5 mg x kg(-1)) was given caudally. The analgesic effect of caudal block was evaluated using the Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) and sedation was assessed using a five-point sedation score. The first analgesic requirement time and the number of supplementary analgesics required by each child in a 24-h

2002 Paediatric anaesthesia Controlled trial quality: uncertain

6143. A comparison study between ketamine and ketamine-promethazine combination for oral sedation in pediatric dental patients. Full Text available with Trip Pro

A comparison study between ketamine and ketamine-promethazine combination for oral sedation in pediatric dental patients. This study compared the incidence of vomiting and the sedative effectiveness of ketamine to a ketamine-prornethazine combination in pediatric dental patients. Twenty-two patients with American Society of Anesthesiologists' classification I physical status who were between the ages of 21 and 43 months were randomly divided into 2 groups. The control group received 10 mg/kg (...) of ketamine orally, whereas the experimental group received 10 mg/kg of ketamine and 1.1 mg/kg of promethazine orally. Nitrous oxide in oxygen was supplemented between 35 and 50%. Each patient received 1 or 2 quadrants of restoration by one operator. Heart rate, blood pressure, and oxygen saturation were monitored and recorded during the treatment. Crying, alertness, movement, and overall general behavior were rated using the scale by Houpt et al. A dentist-anesthesiologist conducted the vital sign

2002 Anesthesia progress Controlled trial quality: uncertain

6144. Hemodynamic stability during induction of anesthesia and tracheal intubation with propofol plus fentanyl, ketamine, and fentanyl-ketamine. (Abstract)

Hemodynamic stability during induction of anesthesia and tracheal intubation with propofol plus fentanyl, ketamine, and fentanyl-ketamine. This study was conducted to investigate hemodynamic and cardiac stability during anesthesia induction and intubation, using propofol plus fentanyl, propofol plus ketamine, and propofol plus fentanyl and ketamine.Forty-five adult patients were randomly allocated to one of three groups according to the agents used for induction: propofol (2 mg/kg) plus (...) fentanyl (3 microg/kg) (PF), propofol (2 mg/kg) plus ketamine (0.1 mg/kg) (PK), and propofol (2 mg/kg) plus fentanyl (3 microg/kg) plus ketamine (0.1 mg/kg) (PFK). Hemodynamic responses were assessed by measuring changes in blood pressure (BP), heart rate (HR), and cardiac output (CO; using dye dilution combined with pulse dye densitometry [PDD]).BP and HR changes during the induction of anesthesia tended to be greater in the PK group than in the PF and PFK groups. After the injection of propofol

2001 Journal of anesthesia Controlled trial quality: uncertain

6145. Experimental comparison of ketamine with a combination of ketamine, butorphanol and medetomidine for general anaesthesia of the Eurasian badger (Meles meles L.). (Abstract)

Experimental comparison of ketamine with a combination of ketamine, butorphanol and medetomidine for general anaesthesia of the Eurasian badger (Meles meles L.). The refinement of anaesthetic regimes is central to improving the welfare of captured wildlife. The Eurasian badger (Meles meles) has been the subject of an intensive long-term ecological and epidemiological study at Woodchester Park, Gloucestershire, England. During routine trapping operations (June 21st, 2000-January 23rd, 2001 (...) ) an experimental trial was conducted on 89 badgers to compare the physiological effects of anaesthesia using ketamine hydrochloride alone, and in conjunction with medetomidine hydrochloride and butorphanol tartrate. The mixture induced a significantly longer period of anaesthesia, and either substantially reduced or eliminated the adverse effects associated with ketamine anaesthesia (e.g., excessive salivation, bouts of sneezing, rough recoveries, and muscle rigidity). In a sub-sample of badgers given

2004 Veterinary journal (London, England : 1997) Controlled trial quality: uncertain

6146. Comparison of analgesic/sedative effect of racemic ketamine and S(+)-ketamine during cardiac catheterization in newborns and children. (Abstract)

Comparison of analgesic/sedative effect of racemic ketamine and S(+)-ketamine during cardiac catheterization in newborns and children. The hypnotic and analgesic effect of ketamine with maintained spontaneous breathing is used for analgesic/sedative anesthesia without the need of intubation. The intention of this study was to compare the efficacy and side effects of racemic ketamine and its enantiomer S(+)-ketamine during cardiac catheterization in newborns and children. One hundred children (...) (ages 0-11 years) were randomly assigned to groups of equal size. The differences between the racemic ketamine/midazolam and the S(+)-ketamine/midazolam groups were investigated regarding the total dosage of sedative drugs, side effects, and the awakening period. The dosage of S(+)-ketamine (2.28 mg/kg/h) was significantly lower than that needed for racemic ketamine (3.12 mg/kg/h) (p = 0.037) with an analgesic/sedative potency ratio of 1.4:1. Balloon dilatation required significantly higher dosages

2003 Pediatric Cardiology Controlled trial quality: uncertain

6147. A randomised, controlled study of peri-operative low dose s(+)-ketamine in combination with postoperative patient-controlled s(+)-ketamine and morphine after radical prostatectomy. (Abstract)

A randomised, controlled study of peri-operative low dose s(+)-ketamine in combination with postoperative patient-controlled s(+)-ketamine and morphine after radical prostatectomy. In a randomised, double-blind prospective study we compared the effects on postoperative pain and analgesic consumption of intra-operative s(+)-ketamine (100 microg.kg-1 bolus and a continuous infusion of 2 microg.kg-1.min-1) followed by postoperative patient-controlled analgesia with morphine (1 mg per bolus) plus s (...) (+)-ketamine (0.5 mg per bolus), or intra-operative saline followed by postoperative patient-controlled analgesia morphine (1 mg per bolus) alone. A total of 28 male patients undergoing radical prostatectomy were studied. Morphine consumption, pain scores, pressure algometry and adverse effects were recorded for 48 h after surgery. Cumulative morphine consumption was significantly lower in the ketamine/morphine group (47.9 +/- 26.2 mg) than in the saline/morphine group (73.4 +/- 34.8 mg; p = 0.049). Pain

2004 Anaesthesia Controlled trial quality: uncertain

6148. Pre-emptive epidural ketamine or S(+)-ketamine in post-incisional pain in dogs: a comparative study. (Abstract)

Pre-emptive epidural ketamine or S(+)-ketamine in post-incisional pain in dogs: a comparative study. To compare the pre-emptive analgesic effects of epidural ketamine or S(+)-ketamine on post-incisional hyperalgesia.Prospective randomized study.Twenty-four mongrel dogs (1-5 years, weighing 11.9+/-1.8 kg).Dogs were anesthetized with propofol (5 mg/kg intravenously) and a lumbosacral epidural catheter was placed. Dogs were randomly allocated to 3 groups, each with 8 dogs. The control group (CG (...) ) was administered saline solution (0.3 mL/kg); the ketamine group (KG) ketamine (0.6 mg/kg); and the S(+)-ketamine group (SG) S(+)-ketamine (0.6 mg/kg). The final volume was adjusted to 0.3 mL/kg in all groups. Five minutes after the epidural injection a surgical incision was made in the common pad of the right hind limb and was immediately closed with simple interrupted nylon suture. Respiratory (RR) and heart (HR) rates, rectal temperature (T), sedation (S), lameness score, and mechanical nociceptive

2004 Veterinary surgery : VS Controlled trial quality: uncertain

6149. Caudal analgesia in children: S(+)-ketamine vs S(+)-ketamine plus clonidine. (Abstract)

Caudal analgesia in children: S(+)-ketamine vs S(+)-ketamine plus clonidine. The aim of this study was to evaluate postoperative analgesia provided by caudal S(+)-ketamine and S(+)-ketamine plus clonidine without local anesthetic.Forty-four children aged 1-5 years consecutively scheduled for inguinal hernia repair, hydrocele repair or orchidopexy were randomly assigned to receive a caudal injection of either S(+)-ketamine 1 mg x kg(-1) (group K) or S(+)-ketamine 0.5 mg x kg(-1) plus clonidine 1 (...) microg x kg(-1) (group KC). Postoperative analgesia and sedation were evaluated by CHEOPS and Ramsay scale from emergence from general anesthesia for 24 h.No statistical difference was observed between study groups with respect to pain and sedation assessment. A slight trend toward a reduced requirement for rescue analgesia in group KC was observed, although not statistically significant.Caudal S(+)-ketamine 1 mg x kg(-1) and S(+)-ketamine 0.5 mg x kg(-1) plus clonidine 1 microg x kg(-1) are safe

2004 Paediatric anaesthesia Controlled trial quality: uncertain

6150. The effects of S+-ketamine and racemic ketamine on uterine blood flow in chronically instrumented pregnant sheep. (Abstract)

The effects of S+-ketamine and racemic ketamine on uterine blood flow in chronically instrumented pregnant sheep. Ketamine could be a useful maternal analgesic in obstetric surgery, as it might avoid the need for opioid administration and associated side effects in the newborn. Racemic ketamine passes the placental barrier and has oxytocin-like properties but does not seem to affect uterine blood flow (UBF). S(+)-ketamine was recently approved for clinical use, but its effects on UBF have (...) not been evaluated. Therefore, we studied the effects of S(+)-ketamine on maternal and fetal hemodynamic variables. Equianalgesic doses of S(+)-ketamine (10 mg.kg(-1).h(-1)) or racemic ketamine (20 mg.kg(-1).h(-1)) were infused in 12 chronically instrumented pregnant sheep. Maternal and fetal vital signs, blood gases, and UBF were recorded over 120 min. Neither compound affected uterine perfusion or maternal and fetal hemodynamics. Whereas racemic ketamine increased maternal (+19%) and fetal (+11%) PCO

2004 Anesthesia and Analgesia

6151. [Endocrine reactions, circulatory and resuscitation behavior in ketamine-midazolam anesthesia. A comparative study of ketamine racemate vs. (S)-ketamine in knee surgery]. (Abstract)

[Endocrine reactions, circulatory and resuscitation behavior in ketamine-midazolam anesthesia. A comparative study of ketamine racemate vs. (S)-ketamine in knee surgery]. Clinically used ketamine is a racemic mixture of two isomers, (S)- and (R)-ketamine, in equal amounts. Previous investigations showed the anaesthetic potency of (S)-ketamine to be three times higher than that of (R)-ketamine. The aim of this study was to compare the effects of (S)-ketamine/midazolam and racemic ketamine (...) /midazolam on endocrine and cardiovascular parameters, recovery, and side effects in unpremedicated patients during knee surgery.41 patients scheduled for elective knee surgery were investigated in a prospective, double-blind, and randomised design. For induction of intravenous anesthesia, patients received 0.1 mg/kg midazolam, 0.003 mg/kg atropine, 1 mg/kg (S)-ketamine or 2 mg/kg racemic ketamine, respectively. For tracheal intubation, 1 mg vecuronium and 1.5 mg/kg suxamethonium were injected. After

1997 Der Anaesthesist Controlled trial quality: uncertain

6152. Comparison of anesthetic and cardiorespiratory effects of diazepam-butorphanol-ketamine, acepromazine-butorphanol-ketamine, and xylazine-butorphanol-ketamine in ferrets. (Abstract)

Comparison of anesthetic and cardiorespiratory effects of diazepam-butorphanol-ketamine, acepromazine-butorphanol-ketamine, and xylazine-butorphanol-ketamine in ferrets. Ten ferrets were used in a crossover study to determine the sedative effects of intramuscularly administered diazepam (3 mg/kg body weight)-butorphanol (0.2 mg/kg body weight)-ketamine (15 mg/kg body weight); acepromazine (0.1 mg/kg body weight)-butorphanol (0.2 mg/kg body weight)-ketamine (15 mg/kg body weight); and xylazine (...) (2 mg/kg body weight)-butorphanol (0.2 mg/kg body weight)-ketamine (15 mg/kg body weight). All of the ferrets became laterally recumbent following the administration of each drug combination. The xylazine-butorphanol-ketamine combination induced significantly longer (p less than 0.05) durations of tail-clamp analgesia (mean+/-standard deviation [SD], 81.0+/-19.1 min versus 20.5+/-25.4 min and 30.0+/-26.9 min), dorsal recumbency (mean+/-SD, 94.6+/-13.6 min versus 75. 6+/-34.7 min and 55.2+24.8 min

1998 Journal of the American Animal Hospital Association Controlled trial quality: uncertain

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