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Ketamine

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81. The role of GSK-3 in treatment-resistant depression and links with the pharmacological effects of lithium and ketamine: A review of the literature. (Abstract)

The role of GSK-3 in treatment-resistant depression and links with the pharmacological effects of lithium and ketamine: A review of the literature. Since the discovery of antidepressants, new treatments have emerged with fewer side effects but no greater efficacy. Glycogen synthase kinase 3 β (GSK-3β), a kinase known for its activity on glycogen synthesis, has in the last few years raised growing interest in biological psychiatry. Several efficient treatments in major depression have (...) -arrestin/AKT, and with the rapid antidepressant effect of ketamine via p70S6K.Our review focuses on mechanisms whereby the GSK-3β pathway has a part in the antidepressant effect of lithium and ketamine. This article highlights the importance of translational research from cell and animal models to the clinical setting in order to develop innovative therapeutic targets.Copyright © 2016 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

2017 L'Encephale

82. Sexual and bladder dysfunction in male ketamine abusers: A large-scale questionnaire study. Full Text available with Trip Pro

Sexual and bladder dysfunction in male ketamine abusers: A large-scale questionnaire study. To evaluate the prevalence of lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) in the illicit male ketamine abusers (KA).The male street KAs caught by policemen and patients visiting urologic clinics were invited to answer a structured questionnaire including demographic data, illicit drug use related details (duration, frequency, dosage and abstinence status), international prostate (...) (OR = 1.765). Subgroup analysis on male street KAs disclosed that abstinence ≧3 months is a protective factor for ED. Lower urinary tract symptoms (ICSI+ICPI ≧12) was prevalent in KAs and multivariate analysis disclosed that significant risk factors for LUTS (ICSI+ICPI ≧12) were age ≧30 years, duration ≧24 months and co-use of other illicit drugs.Male ED and LUTS were frequently observed in the ketamine abusers. We suggested that street ketamine abuse should be considered in young men presented with ED

2018 PLoS ONE

83. Using Neuroimaging to Decipher the Mechanism of Action of Ketamine: A Pathway to Novel Therapeutics? Full Text available with Trip Pro

Using Neuroimaging to Decipher the Mechanism of Action of Ketamine: A Pathway to Novel Therapeutics? 29560906 2019 02 27 2019 02 27 2451-9030 2 7 2017 10 Biological psychiatry. Cognitive neuroscience and neuroimaging Biol Psychiatry Cogn Neurosci Neuroimaging Using Neuroimaging to Decipher the Mechanism of Action of Ketamine: A Pathway to Novel Therapeutics? 549-551 S2451-9022(17)30146-5 10.1016/j.bpsc.2017.08.006 Nugent Allison C AC Experimental Therapeutics and Pathophysiology Branch

2017 Biological psychiatry. Cognitive neuroscience and neuroimaging

84. Prefrontal Connectivity and Glutamate Transmission: Relevance to Depression Pathophysiology and Ketamine Treatment Full Text available with Trip Pro

Prefrontal Connectivity and Glutamate Transmission: Relevance to Depression Pathophysiology and Ketamine Treatment Prefrontal global brain connectivity with global signal regression (GBCr) was proposed as a robust biomarker of depression, and was associated with ketamine's mechanism of action. Here, we investigated prefrontal GBCr in treatment-resistant depression (TRD) at baseline and following treatment. Then, we conducted a set of pharmacological challenges in healthy subjects to investigate (...) the glutamate neurotransmission correlates of GBCr.In study A, we used functional magnetic resonance imaging (fMRI) to compare GBCr between 22 TRD and 29 healthy control. Then, we examined the effects of ketamine and midazolam on GBCr in TRD patients 24h post-treatment. In study B, we acquired repeated fMRI in 18 healthy subjects to determine the effects of lamotrigine (a glutamate release inhibitor), ketamine, and lamotrigine-by-ketamine interaction.In study A, TRD patients showed significant reduction

2017 Biological psychiatry. Cognitive neuroscience and neuroimaging

85. Use of Intranasal Ketamine in Pediatric Patients in the Emergency Department. (Abstract)

Use of Intranasal Ketamine in Pediatric Patients in the Emergency Department. Ketamine is a safe and widely used sedative and analgesic in the pediatric emergency department (ED). The use of intranasal (IN) ketamine in exchange for the administration of intravenous sedatives or analgesics for procedural sedation in pediatric patients is not commonplace. The goal of this study was to evaluate provider perceptions and patient outcomes at varying doses of IN ketamine for anxiolysis, agitation (...) , or analgesia.From January 2018 to May 2018, we performed a prospective survey and chart review of pediatric patients receiving IN ketamine. The primary outcome was to determine provider satisfaction with using IN ketamine. Secondary objectives included comparing outcomes stratified by dose, adverse events, assessing for treatment failure, and ED length of stay (LOS). As a secondary comparison, patients receiving IN ketamine whom otherwise would have required procedural sedation with intravenous sedatives

2019 Pediatric Emergency Care

86. Comparison of Intranasal Dexmedetomidine and Oral Ketamine Versus Intranasal Midazolam Premedication for Children Undergoing Dental Rehabilitation. Full Text available with Trip Pro

Comparison of Intranasal Dexmedetomidine and Oral Ketamine Versus Intranasal Midazolam Premedication for Children Undergoing Dental Rehabilitation. Dental rehabilitation surgery is associated with significant fear and anxiety with subsequent psychological disturbances. Midazolam has been used frequently as a premedication. However, it may be associated with side effects. Dexmedetomidine and ketamine combination has been suggested as an effective premedication in improving preoperative sedation (...) and analgesia.This study compared the effects of combined intranasal dexmedetomidine and oral ketamine versus intranasal midazolam on anxiolysis and postoperative analgesia.Seventy-six children (aged two to six years) undergoing dental rehabilitation under general anesthesia were assigned randomly to one of the two groups (n = 38 each) receiving either intranasal dexmedetomidine at 2 µg/kg and oral ketamine at 3 mg/kg (Group DK) or intranasal midazolam at 0.2 mg/kg (group M) 30 minutes prior to the anesthesia

2019 Anesthesiology and pain medicine Controlled trial quality: uncertain

87. Dextromethorphan and memantine after ketamine analgesia: a randomized control trial. Full Text available with Trip Pro

Dextromethorphan and memantine after ketamine analgesia: a randomized control trial. Intravenous ketamine is often prescribed in severe neuropathic pain. Oral N-methyl-D-aspartate receptor (NMDAR) antagonists might prolong pain relief, reducing the frequency of ketamine infusions and hospital admissions. This clinical trial aimed at assessing whether oral dextromethorphan or memantine might prolong pain relief after intravenous ketamine.A multicenter randomized controlled clinical trial (...) included 60 patients after ketamine infusion for refractory neuropathic pain. Dextromethorphan (90 mg/day), memantine (20 mg/day) or placebo was given for 12 weeks (n=20 each) after ketamine infusion. The primary endpoint was pain intensity at one month. Secondary endpoints included pain, sleep, anxiety, depression, cognitive function and quality of life evaluations up to 12 weeks.At 1 month, dextromethorphan maintained ketamine pain relief (Numeric Pain Scale: 4.01±1.87 to 4.05±2.61, p=0.53

2019 Drug design, development and therapy Controlled trial quality: uncertain

88. Preemptive Effect of Intraurethral Instillation of Ketamine-lidocaine Gel on Postoperative Catheter-related Bladder Discomfort after Lumbar Spine Surgery. Full Text available with Trip Pro

Preemptive Effect of Intraurethral Instillation of Ketamine-lidocaine Gel on Postoperative Catheter-related Bladder Discomfort after Lumbar Spine Surgery. Catheter-related bladder discomfort (CRBD) is one of the main reasons of agitation after surgery, leading to urgency and frequency during recovery. Ketamine has been used as an effective drug for reducing the signs and severity of this problem. We hypothesized that intraurethral instillation of ketamine-lidocaine gel before urinary (...) catheterization can reduce the incidence of CRBD in the postoperative period.A total of 136 male patients, who underwent two-level laminectomy/discectomy were enrolled in this randomized clinical trial. Patients were randomized into the two groups before urinary catheterization. The ketamine group received urethral lubrication with 5 mL xylocaine jelly (2%) in conjunction with 2 mL (100 mg) ketamine. Patients in control group received urethral lubrication with 5 mL xylocaine jelly (2%) in conjunction with 2

2019 Asian journal of neurosurgery Controlled trial quality: uncertain

89. Comparison of intradermal Dexmedmotidine and subcutaneous Ketamine for post-surgical pain management in patients with abdominal hysterectomy. Full Text available with Trip Pro

Comparison of intradermal Dexmedmotidine and subcutaneous Ketamine for post-surgical pain management in patients with abdominal hysterectomy. Hysterectomy after cesarean section is the second most commonly used surgery for women in the United States. One of the most common problem after hysterectomy is pain. We decided to compare the effects of dexmedmotidine or ketamine on pain in patients by a double blind randomized clinical trial on 126 female candidates for abdominal hysterectomy in three (...) groups of 42 persons referred to Taleghani hospital in Arak. For the first group, 50 micrograms of intradermal dexmedmotidine were injected, while in the second group, patients were injected with 100 mg of subcutaneous ketamine and the third group received 5 cc normal saline. Data were next analyzed by SPSS version 19. The mean age and body mass index of the patients were not significantly different in the three groups. The mean scores of pain during recovery of patients in ketamine, dexmedmotidine

2019 European journal of translational myology Controlled trial quality: uncertain

90. [Ketamine as an adjunct to bupivacaine in infra-orbital nerve block analgesia after cleft lip repair]. Full Text available with Trip Pro

[Ketamine as an adjunct to bupivacaine in infra-orbital nerve block analgesia after cleft lip repair]. We conducted this study to investigate the safety and analgesic efficacy of the addition of Ketamine to Bupivacaine in bilateral extra-oral infra-orbital nerve block in children undergoing cleft lip surgeries.Sixty patients were randomly allocated into two groups (n=30), Group B received infra-orbital nerve block with 2mL of 0.25% Bupivacaine and Group BK received 0.5mg.kg-1 Ketamine for each (...) ) and in the first hour (h) postoperatively (1.40±0.17 vs. 0.67±0.14, p<0.003). Higher parent satisfaction scores were recorded in Group BK (p<0.04) without significant adverse effects.The addition of Ketamine to Bupivacaine has accentuated the analgesic efficacy of infra-orbital nerve block in children undergoing cleft lip repair surgeries.Copyright © 2018 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

2019 Revista brasileira de anestesiologia Controlled trial quality: uncertain

91. Association between dynamic resting-state functional connectivity and ketamine plasma levels in visual processing networks. Full Text available with Trip Pro

Association between dynamic resting-state functional connectivity and ketamine plasma levels in visual processing networks. Numerous studies demonstrate ketamine's influence on resting-state functional connectivity (rsFC). Seed-based and static rsFC estimation methods may oversimplify FC. These limitations can be addressed with whole-brain, dynamic rsFC estimation methods. We assessed data from 27 healthy subjects who underwent two 3 T resting-state fMRI scans, once under subanesthetic (...) suggesting that esketamine's influence on dynamic rsFC is highly stable in visual processing networks. Our findings may be reflective of ketamine's role as a model for psychosis, a disorder associated with alterations to visual processing and impaired inter-hemispheric connectivity. Ketamine is a highly effective antidepressant and studies have shown changes to sensory processing in depression. Dynamic rsFC in sensory processing networks might be a promising target for future investigations of ketamine's

2019 Scientific reports Controlled trial quality: uncertain

92. A reply to comments by Lee and colleagues on: Repeated intranasal ketamine for treatment resistant depression - the way to go? Results from a pilot randomised controlled trial. (Abstract)

A reply to comments by Lee and colleagues on: Repeated intranasal ketamine for treatment resistant depression - the way to go? Results from a pilot randomised controlled trial. 30773113 2019 11 20 1461-7285 33 2 2019 Feb Journal of psychopharmacology (Oxford, England) J. Psychopharmacol. (Oxford) A reply to comments by Lee and colleagues on: Repeated intranasal ketamine for treatment resistant depression - the way to go? Results from a pilot randomised controlled trial. 260-261 10.1177

2019 Journal of psychopharmacology (Oxford, England) Controlled trial quality: uncertain

93. A Comparative Evaluation of the Sedative Effects of Nitrous Oxide-oxygen Inhalation and Oral Midazolam-Ketamine Combination in Children. Full Text available with Trip Pro

A Comparative Evaluation of the Sedative Effects of Nitrous Oxide-oxygen Inhalation and Oral Midazolam-Ketamine Combination in Children. To compare nitrous oxide-oxygen inhalation and low dose oral midazolam-ketamine combination for anxiolysis in the management of children aged between 3 to 10 years for dental treatment.A comparative clinical study with equal number of subjects in both the groups evaluating efficacy of oral ketamine-midazolam combination and nitrous oxide-oxygen inhalation (...) in children with Frankl behavior rating score 2 and ASA1.A total of 30 children were equally divided into 2 groups, oral midazolam-ketamine (MK) group which received 0.25mg/ kg midazolam with 3mg/kg ketamine in combination and the Nitrous oxide-oxygen (N) group which received nitrous oxide-oxygen inhalation. The parameters evaluated were the drug/ mask acceptance, need for the use of a physical restraint. Houpt's sedation scale, faces pain score, sedation duration, time taken to achieve the maximum

2019 International journal of clinical pediatric dentistry Controlled trial quality: uncertain

94. Administration of Sub-anesthetic Dose of Ketamine and Electroconvulsive Treatment on Alternate Week Days in Patients with Treatment Resistant Depression: A Double Blind Placebo Controlled Trial. (Abstract)

Administration of Sub-anesthetic Dose of Ketamine and Electroconvulsive Treatment on Alternate Week Days in Patients with Treatment Resistant Depression: A Double Blind Placebo Controlled Trial. Patients with depression who fail to respond to at least two antidepressants in their current episode are considered to have Treatment Resistant Depression (TRD). ECT is an effective treatment of TRD but cognitive side effects limit its use. Ketamine elicits a rapid antidepressant response in sub (...) -anesthetic repeated doses. ECT and ketamine may be modulating the glutamate system, therefore when administered in an interleaved fashion, they could have a synergistic effect.15 TRD patients were recruited and 12 were included in the analysis. Patients were randomly assigned to an ECT + iv. ketamine or ECT + iv. placebo (midazolam). At baseline and before each infusion, depression severity scales were administered. At baseline, halfway through and at the end of the study, cognitive tests were

2019 Psychopharmacology Bulletin Controlled trial quality: uncertain

95. Prevention of Shivering during Spinal Anesthesia: Comparison between Tramadol, Ketamine and Ondansetron. (Abstract)

Prevention of Shivering during Spinal Anesthesia: Comparison between Tramadol, Ketamine and Ondansetron. Shivering is an unpleasant experience after spinal anesthesia. We conducted this study to evaluate the efficacy of ondansetron, ketamine and tramadol for prevention of shivering.In this randomized controlled study, 120 patients aged 18-65 years of American Society of Anesthesiologist (ASA) physical status I and II undergoing various surgical procedures were included and allocated alternately (...) to one of the 4 groups; Normal saline (Group1), Ondansetron 4mg (Group2), Ketamine 0.25mg/kg (Group3) and Tramadol 0.5mg/kg (Group4). Incidence of shivering, effect on hemodynamics, nausea, vomiting, sedation and emergence reactions were recorded. Data was analyzed using SPSS (The Statistical Package for Social Sciences) version 20.0 software.The patients were comparable in terms of demographic variables, baseline temperature, type of surgery, median level of sensory blockade, duration of surgery

2019 JNMA; journal of the Nepal Medical Association Controlled trial quality: uncertain

96. Clinical and pharmacokinetic interactions between oral fluconazole and intravenous ketamine and midazolam in dogs. (Abstract)

Clinical and pharmacokinetic interactions between oral fluconazole and intravenous ketamine and midazolam in dogs. To evaluate drug interactions between fluconazole and the intravenous (IV) anesthetic induction agents, ketamine and midazolam.Randomized parallel study.A group of 12 adult healthy Beagle dogs.Dogs were randomly allocated to two groups of six dogs. Dogs in group KM were administered IV ketamine (7 mg kg-1) and IV midazolam (0.25 mg kg-1), and dogs in group KMF were administered (...) fluconazole (5 mg kg-1) orally 12 and 24 hours prior to ketamine-midazolam using the same doses as KM. Sedation scores (0-4) were assigned by investigators unaware of group assignment. Heart rate (HR) and times to sternal and standing were obtained and compared between groups for differences with p < 0.05 considered statistically significant. Blood was obtained and plasma drug concentrations were measured using liquid chromatography-mass spectrometry.The times to sternal, mean 32.3 and 24.6 minutes

2019 Veterinary anaesthesia and analgesia Controlled trial quality: uncertain

97. The comparison of dexmedetomidine and ketamine for pediatric dental surgery: A meta-analysis of randomized controlled studies. Full Text available with Trip Pro

The comparison of dexmedetomidine and ketamine for pediatric dental surgery: A meta-analysis of randomized controlled studies. Dexmedetomidine and ketamine are used for the sedation of pediatric dental surgery. We conduct a systematic review and meta-analysis to compare the sedation of dexmedetomidine and ketamine for pediatric dental surgery.PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched. Randomized controlled trials (RCTs) assessing the influence (...) of dexmedetomidine versus ketamine on pediatric dental surgery are included. Two investigators independently have searched articles, extracted data, and assessed the quality of included studies. This meta-analysis is performed using the random-effect model.Four RCTs involving 163 children are included in the meta-analysis. Compared with ketamine for pediatric dental surgery, dexmedetomidine results in comparable sedation level (very low quality, 2 RCTs, n = 40; Std. MD = -0.26; 95% CI = -0.74 to 0.23; P = .31

2019 Medicine

98. Microglial production of quinolinic acid as a target and a marker of the antidepressant effect of ketamine. Full Text available with Trip Pro

Microglial production of quinolinic acid as a target and a marker of the antidepressant effect of ketamine. Major depressive disorder is a complex multifactorial condition with a so far poorly characterized underlying pathophysiology. Consequently, the available treatments are far from satisfactory as it is estimated that up to 30% of patients are resistant to conventional treatment. Recent comprehensive evidence has been accumulated which suggests that inflammation may be implied (...) in the etiology of this disease. Here we investigated ketamine as an innovative treatment strategy due to its immune-modulating capacities. In a murine model of LPS-induced depressive-like behavior we demonstrated that a single dose of ketamine restores the LPS-induced depressive-like alterations. These behavioral effects are associated with i/ a reversal of anxiety and reduced self-care, ii/ a decrease in parenchymal cytokine production, iii/ a modulation of the microglial reactivity and iv/ a decrease

2019 Brain, behavior, and immunity

99. Low-dose ketamine adjuvant treatment for refractory pain in children, adolescents and young adults with cancer: a pilot study. (Abstract)

Low-dose ketamine adjuvant treatment for refractory pain in children, adolescents and young adults with cancer: a pilot study. Ketamine, an N-methyl-D-aspartate receptor antagonist, is effective at relieving adult cancer pain, although there have been very few reports to date regarding its use in children and in adolescents and young adults (AYA). This study assessed the efficacy, safety and opioid-sparing effects of low doses of ketamine added to opioid analgesics to alleviate persistent (...) cancer pain.This prospective, multicentre, observational trial collected data regarding demographics, pain characteristics, pain score assessment within the first 48 hours of ketamine administration, tolerance and satisfaction from 38 patients aged 2-24 years prescribed with ketamine as an adjuvant antalgic for refractory cancer pain in 10 French paediatric oncology centres.The mean visual analogue scale pain score decreased from 6.7 to 4.3 out of 10 (n=39, p<0.001) from day 1 to day 3

2019 BMJ Supportive & Palliative Care

100. Subanesthetic Dose of Ketamine Improved CFA-induced Inflammatory Pain and Depression-like Behaviors Via Caveolin-1 in Mice. (Abstract)

Subanesthetic Dose of Ketamine Improved CFA-induced Inflammatory Pain and Depression-like Behaviors Via Caveolin-1 in Mice. Ketamine, a commonly used nonbarbiturate anesthetic drug, possesses antidepressant properties at subanesthetic doses; however, the underlying mechanisms remain unclear.The analgesic and antidepressant effects of ketamine were explored using a complete Freund adjuvant (CFA)-induced peripheral inflammatory pain model in vivo. Mice were first divided into sham or CFA (...) injection group randomly, and were observed for mechanical hyperalgesia, depression-like behavior, and mRNA expression of caveolin-1. Then ketamine was administered in CFA-treated mice at day 7.The behavioral testing results revealed mechanical hyperalgesia and depression in mice from days 7 to 21 after CFA injection. Ketamine reversed depression-like behaviors induced by CFA injection. It also restored the brain-regional expression levels of caveolin-1 in CFA-treated mice. In addition, caveolin-1 mRNA

2019 Journal of neurosurgical anesthesiology

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