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Ketamine

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141. Ketamine/propofol admixture vs etomidate for intubation in the critically ill: KEEP PACE Randomized clinical trial. (Abstract)

Ketamine/propofol admixture vs etomidate for intubation in the critically ill: KEEP PACE Randomized clinical trial. Periintubation hypotension is associated with poor outcomes in the critically ill. We aimed to determine if an admixture of ketamine and propofol for emergent endotracheal intubation in critically ill patients was superior to etomidate. Primary endpoint was the change in mean arterial pressure from baseline to 5 minutes postdrug administration.Emergent-use, stratified (shock (...) status and unit type), multiunit, randomized, parallel-group superiority clinical trial was conducted at a tertiary academic medical center. Adult medical/surgical and transplant/oncologic intensive care unit patients undergoing emergent intubation were assigned randomly to receive either ketamine/propofol admixture (0.5 mg/kg of ketamine and propofol each) or reduced dose etomidate (0.15 mg/kg) for emergent intubation.One hundred sixty participants were randomized, and 152 (79 ketamine/propofol

2019 The journal of trauma and acute care surgery Controlled trial quality: predicted high

142. The Efficacy of Intraoperative Ketamine-Haloperidol for Prevention of Catheter-related Bladder Discomfort After Lumbar Spinal Stenosis Surgery. Full Text available with Trip Pro

The Efficacy of Intraoperative Ketamine-Haloperidol for Prevention of Catheter-related Bladder Discomfort After Lumbar Spinal Stenosis Surgery. Catheterization of urinary bladder during surgery frequently leads to agitation of the patient in the recovery room, especially in those patients who remain catheterized after gaining consciousness. We hypothesized that administration of a combination of ketamine-haloperidol (KH) before urinary catheterization would reduce the incidence of catheter (...) -related bladder discomfort (CRBD) while reducing some adverse effects of ketamine in the postoperative period.A total of 119 male patients who underwent lumbar spinal stenosis surgery were randomized into three groups. The KH group consisted of 39 patients who received KH just before urinary catheterization. The second arm of the study including 40 patients who received pethidine-haloperidol (PH). The control (C) group consisted of 40 patients who received normal saline as a placebo. We sought

2019 Oman medical journal Controlled trial quality: uncertain

143. [Tourniquet-induced ischaemia-reperfusion injury: the comparison of antioxidative effects of small-dose propofol and ketamine]. Full Text available with Trip Pro

[Tourniquet-induced ischaemia-reperfusion injury: the comparison of antioxidative effects of small-dose propofol and ketamine]. The aim of the present study was to investigate the preventive effects of propofol and ketamine as small dose sedation during spinal anesthesia on tourniquet-induced ischemia-reperfusion injury.30 patients were randomly assigned into two groups of 15 patients. In the propofol group, sedation was performed with propofol 0.2mg.kg-1 followed by infusion at a rate (...) of 2mg.kg-1.h-1. In the ketamine group, a continuous infusion of ketamine 0.5mg.kg-1.h-1 was used until the end of surgery. Intravenous administration of midazolam was not used in any patients. Ramsay sedation scale was used for assessing the sedation level. Venous blood samples were obtained before propofol and ketamine infusion (T1), at 30minutes (min) of tourniquet ischemia (T2), and 5min after tourniquet deflation (T3) for malondialdehyde (MDA) measurements.No differences were noted between

2019 Revista brasileira de anestesiologia Controlled trial quality: uncertain

144. A comparison between intravenous lidocaine and ketamine on acute and chronic pain after open nephrectomy: A prospective, double-blind, randomized, placebo-controlled study. Full Text available with Trip Pro

A comparison between intravenous lidocaine and ketamine on acute and chronic pain after open nephrectomy: A prospective, double-blind, randomized, placebo-controlled study. Recently, there has been increasing interest in the use of analgesic adjuncts such as intravenous (IV) ketamine and lidocaine.To compare the effects of perioperative IV lidocaine and ketamine on morphine requirements, pain scores, quality of recovery, and chronic pain after open nephrectomy.A prospective, randomized, placebo (...) -controlled, double-blind trial.The study was conducted in Charles Nicolle University Hospital of Tunis.Sixty patients were randomly allocated to receive IV lidocaine: bolus of 1.5 mg/kg at the induction of anesthesia followed by infusion of 1 mg/kg/h intraoperatively and for 24 h postoperatively or ketamine: bolus of 0.15 mg/kg followed by infusion of 0.1 mg/kg/h intraoperatively and for 24 h postoperatively or an equal volume of saline (control group [CG]).Morphine consumption, visual analog scale pain

2019 Saudi journal of anaesthesia Controlled trial quality: predicted high

145. Repeated ketamine infusions for antidepressant-resistant PTSD: Methods of a multicenter, randomized, placebo-controlled clinical trial. (Abstract)

Repeated ketamine infusions for antidepressant-resistant PTSD: Methods of a multicenter, randomized, placebo-controlled clinical trial. Posttraumatic stress disorder (PTSD) is a debilitating disorder with limited medication treatment options. Recent reports have described the dearth of research on new drug development as a crisis in the pharmacotherapy of PTSD. There are only two PTSD medications approved by the U.S. Food and Drug Administration, and both are serotonergic antidepressants (...) . Therefore, there is a tremendous need to identify more effective and more rapidly acting pharmacotherapies for PTSD that work through novel neural mechanisms. Pilot evidence and case reports provided preliminary evidence supporting the safety and utility of investigating the therapeutic effects of ketamine in PTSD. However, the efficacy of this drug for PTSD has not yet been tested in active duty military or veteran populations. Here, we report the design and methods of a study funded under

2019 Contemporary clinical trials Controlled trial quality: predicted high

146. Efficacy and Tolerability of Sufentanil, Dexmedetomidine, or Ketamine Added to Propofol-based Sedation for Gastrointestinal Endoscopy in Elderly Patients: A Prospective, Randomized, Controlled Trial. (Abstract)

Efficacy and Tolerability of Sufentanil, Dexmedetomidine, or Ketamine Added to Propofol-based Sedation for Gastrointestinal Endoscopy in Elderly Patients: A Prospective, Randomized, Controlled Trial. To investigate the optimal agent combined with propofol for sedation in elderly patients undergoing gastrointestinal endoscopy.A total of 120 elderly patients scheduled for gastrointestinal endoscopy under propofol-based sedation were randomly allocated to receive propofol + saline (control group (...) ), propofol + sufentanil 0.1 μg/kg, propofol + dexmedetomidine 0.4 μg/kg, or propofol + ketamine 0.4 mg/kg. Mean arterial pressure, heart rate, pulse oximetry, pressure of end-tidal carbon dioxide, respiratory rate, and Ramsay sedation scale score were recorded. Induction time, procedure time, recovery time, propofol dose, and adverse events were also recorded.During the sedation procedure, the AUC of HR was lowest in the propofol + dexmedetomidine group (all, P < 0.05), and the AUC of pulse oximetry

2019 Clinical therapeutics Controlled trial quality: uncertain

147. Comparison of the Analgesic Effect of Intravenous Ketamine versus Intravenous Morphine in Reducing Pain of Renal Colic Patients: Double-Blind Clinical Trial Study. (Abstract)

Comparison of the Analgesic Effect of Intravenous Ketamine versus Intravenous Morphine in Reducing Pain of Renal Colic Patients: Double-Blind Clinical Trial Study. The effective relief of renal colic patients with low complications is one of the important concerns of emergency physicians. The aim of this study was to investigate the use of injectable ketamine as an alternative to routine drugs in the relief of pain in patients with renal colic.This double-blind clinical trial was conducted (...) on patients who had suffered kidney pain due to kidney stones in 2017, referred to Ahvaz Imam Khomeini Hospital. Patients were divided into 2 groups: the first group received intravenous ketamine (0.3 mg/kg) and the second group received intravenous morphine (0.1 mg/kg) in a double-blind form. Finally, the mean pain was evaluated before injection, after 10, 20, 30, and 60 minutes as the initial result while the side effects were considered as secondary results.In this study, 135 patients with renal colic

2019 Reviews on recent clinical trials Controlled trial quality: uncertain

148. Lornoxicam with Low-Dose Ketamine versus Pethidine to Control Pain of Acute Renal Colic. Full Text available with Trip Pro

Lornoxicam with Low-Dose Ketamine versus Pethidine to Control Pain of Acute Renal Colic. This study was established to compare single-dose lornoxicam 8 mg (NSAID) in addition to 0.15 mg.kg-1 ketamine with single-dose pethidine 50 mg, both administered intravenously (IV), on the quickness and extent of analgesia, disadvantage, and consequence on utilitarian situation.One hundred and twenty patients with acute renal colic pain received in emergency room were included in this prospective (...) , randomized, and double blind clinical study. They were aimlessly designated into one of two groups using a computer-generated table. Group L received lornoxicam 8 mg IV plus 0.15 mg.kg-1 ketamine and Group P received pethidine 50 mg IV. Parameters were noticed at baseline and after 0, 15, 30, and 45 minutes and 1 hour after drug administration. The efficiency of the drug was determined by observing: patient rated pain, time to pain relief, rate of pain recurrence, the need for rescue analgesia, adverse

2019 Pain research and treatment Controlled trial quality: uncertain

149. Use of Butorphanol, Fentanyl, and Ketamine as Co-Induction Agents with Propofol for Laryngeal Mask Airway Insertion: A Comparative Study. Full Text available with Trip Pro

Use of Butorphanol, Fentanyl, and Ketamine as Co-Induction Agents with Propofol for Laryngeal Mask Airway Insertion: A Comparative Study. Management of airway is of great importance in the practice of anesthesia. Supraglottic airway devices, such as laryngeal mask airway (LMA), have greatly revolutionized the management of airway both in terms of ease and degree of invasiveness. Propofol, by its inherent property of decreasing airway reflexes, is used to aid in LMA insertion. In this study, we (...) have evaluated the LMA insertion conditions and hemodynamic stability, comparing butorphanol, fentanyl, and ketamine as co-induction agents with propofol.A total of 90 female patients planned to undergo minor gynecological procedures were randomly allocated to one of the three study groups. Patients in Group B received butorphanol 20 μg/kg, patients in Group F received fentanyl 1 μg/kg, and patients in Group K received ketamine 0.5 mg/kg intravenously before injection of propofol 2.5 mg/kg. LMA

2019 Anesthesia, essays and researches Controlled trial quality: uncertain

150. Preemptive Epidural Analgesia for Postoperative Pain Relief Revisited: Comparison of Combination of Buprenorphine and Neostigmine with Combination of Buprenorphine and Ketamine in Lower Abdominal Surgeries, A Double-blind Randomized Trial. Full Text available with Trip Pro

Preemptive Epidural Analgesia for Postoperative Pain Relief Revisited: Comparison of Combination of Buprenorphine and Neostigmine with Combination of Buprenorphine and Ketamine in Lower Abdominal Surgeries, A Double-blind Randomized Trial. Postoperative pain relief provides subjective comfort to patient in addition to blunting of autonomic and somatic reflex responses to pain, subsequently enhancing restoration of function by allowing the patient to breathe, cough, and move easily.The aim (...) is to evaluate and compare the effects of neostigmine + buprenorphine and ketamine + buprenorphine for preemptive epidural analgesia for postoperative pain relief in patients undergoing abdominal surgeries under general anesthesia (GA).A double-blind randomized trial.A total of 60 American Society of Anesthesiologists physical status Classes I and II patients undergoing abdominal surgeries under GA were taken up for the study. They were randomly allocated into two groups, Group A and Group B of thirty

2019 Anesthesia, essays and researches Controlled trial quality: uncertain

151. The NEO-FFI domain of openness to experience moderates ketamine response in treatment resistant depression. Full Text available with Trip Pro

The NEO-FFI domain of openness to experience moderates ketamine response in treatment resistant depression. There are many putative mechanisms by which ketamine has its effect and many unanswered questions about risks and benefits of long-term ketamine therapy. A research imperative is the identification of predictors of response to intravenous ketamine, especially a sustained response to maintenance ketamine. Temperament is an inherited aspect of personality and is a predictive factor (...) for outcome in treatment resistant depressed (TRD) patients.We analyzed which domains of personality impacted initial and sustained ketamine response. Utilizing the Neuroticism Extraversion Openness Five Factor Inventory (NEO-FFI) on 125 participants with TRD, we tested (1) whether the degree of neuroticism predicted initial and/or sustained response to ketamine; and (2) whether extraversion, agreeableness, openness to experience, and conscientiousness had an impact on response.Our findings confirmed

2019 Journal of Affective Disorders

152. Repeated intravenous infusions of ketamine: Neurocognition in patients with anxious and nonanxious treatment-resistant depression. (Abstract)

Repeated intravenous infusions of ketamine: Neurocognition in patients with anxious and nonanxious treatment-resistant depression. Recent studies have suggested that neurocognition is changed after repeated infusions of ketamine in patients with treatment-resistant depression (TRD). The objective of this study was to investigate whether differences existed in the neurocognitive effect of six ketamine infusions in patients with anxious and nonanxious TRD and to determine the association between (...) baseline neurocognition and changes in symptoms after the infusions.Patients with anxious (n = 30) and nonanxious TRD (n = 20) received six intravenous infusions of ketamine (0.5 mg/kg over 40 min) over 12 days. Speed of processing (SOP), working memory (WM), verbal learning and memory (VBM), visual learning and memory (VSM) and the severity of depressive and anxious symptoms were assessed at baseline, one day after the last infusion (day 13) and two weeks after the completion of the serial infusions

2019 Journal of Affective Disorders

153. Antidepressant and antisuicidal effects of ketamine on the functional connectivity of prefrontal cortex-related circuits in treatment-resistant depression: A double-blind, placebo-controlled, randomized, longitudinal resting fMRI study. (Abstract)

Antidepressant and antisuicidal effects of ketamine on the functional connectivity of prefrontal cortex-related circuits in treatment-resistant depression: A double-blind, placebo-controlled, randomized, longitudinal resting fMRI study. Increasing evidence suggests that infusion of a subanesthetic dose of ketamine exerts antidepressant and antisuicidal effects in patients with treatment-resistant depression (TRD).In this investigation, we used the resting functional connectivity magnetic (...) resonance imaging (fcMRI) to determine the effects of ketamine on the functional connectivity (FC) of prefrontal cortex (PFC)-related circuits in patients with TRD.Forty-eight patients with TRD were recruited and randomly divided into three groups on the basis of ketamine infusion dose: 0.5 mg/kg (standard dose), 0.2 mg/kg (low dose), or normal saline (a placebo infusion). Resting functional MRI data and clinical data were recorded at the baseline and on the third day after ketamine infusion

2019 Journal of Affective Disorders Controlled trial quality: uncertain

154. Time to relapse after a single administration of intravenous ketamine augmentation in unipolar treatment-resistant depression. Full Text available with Trip Pro

Time to relapse after a single administration of intravenous ketamine augmentation in unipolar treatment-resistant depression. To examine the rate and time to relapse for remitters and responders to ketamine in treatment-resistant depression (TRD).Subjects with TRD were randomized to a single infusion of one of several doses of intravenous ketamine, or midazolam. Using Kaplan-Meier survival function, the current report examines the rate and time to relapse, defined as MADRS ≥ 22, over a period (...) of 30 days, in subjects who achieved remission (MADRS ≤ 10) or response (≥ 50% reduction in MADRS) on day three post-infusion of intravenous ketamine 0.1, 0.5, or 1.0 mg/kg.Of the 60 randomized participants who received a single ketamine (0.1, 0.5, or 1.0 mg/kg) infusion, 19 (34%) met criteria for remission and 27 (48%) for response, on day 3 post-infusion. A numerical dose-response relationship was observed, with remitters/responders on ketamine 1.0 mg/kg having the lowest relapse rate, followed

2019 Journal of Affective Disorders

155. Impact of a ketamine sedation protocol on intubation rates and undesirable outcomes in the transport of patients with acute behavioural disturbance. (Abstract)

Impact of a ketamine sedation protocol on intubation rates and undesirable outcomes in the transport of patients with acute behavioural disturbance. To identify the effects of the introduction of a ketamine sedation protocol on the rates of intubation and adverse events associated with retrieval of patients with acute behavioural disturbance. Transport of patients with acute behavioural disturbance poses clinical and logistical management difficulties, as well as risks. Remote Australian (...) communities are separated by vast distances. Risks to aircraft and crew, and patient and community must be balanced. Ketamine has received increasing attention in recent years for pre-hospital sedation of behaviourally disturbed patients, predominantly with psychiatric illness. This paper explores the benefits and suitability of ketamine in undifferentiated presentations, using data from the retrieval service in Alice Springs, Australia.A pre- and post-intervention study was carried out. The intervention

2019 Emergency medicine Australasia

156. Association between depression subtypes and response to repeated-dose intravenous ketamine. (Abstract)

Association between depression subtypes and response to repeated-dose intravenous ketamine. About half or more of treatment-resistant depressed patients do not respond to ketamine, and few clinical predictors to gauge the most likely antidepressant response have been proposed. We explored whether depression subtypes are associated with response to ketamine.Ninety-seven participants with depression were administered six repeated-dose intravenous ketamine and assessed for depression (Montgomery (...) for ketamine as a novel antidepressant preferentially for the treatment of non-melancholic or anxious depression.© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

2019 Acta Psychiatrica Scandinavica

157. Maintenance of antidepressant and antisuicidal effects by D-cycloserine among patients with treatment-resistant depression who responded to low-dose ketamine infusion: a double-blind randomized placebo-control study. (Abstract)

Maintenance of antidepressant and antisuicidal effects by D-cycloserine among patients with treatment-resistant depression who responded to low-dose ketamine infusion: a double-blind randomized placebo-control study. Increasing evidence supports a rapid antidepressant and antisuicidal effect of a single subanesthetic dose of ketamine infusion for treatment-resistant depression (TRD). Maintaining the initial clinical response after ketamine infusion in TRD is a crucial next-step challenge. D (...) -cycloserine (DCS), a partial agonist of the glycine co-agonist of the N-methyl-D-aspartate (NMDA) glutamate receptor, is potentially effective as a depression augmentation treatment. However, whether DCS maintains the antidepressant and antisuicidal effects of ketamine infusion remains unknown. In all, 32 patients with TRD (17 with major depression and 15 with bipolar depression) who responded to ketamine infusion with an average 17-item Hamilton Depression Rating Scale (HAMD) score of 9.47 ± 4.11

2019 Neuropsychopharmacology Controlled trial quality: uncertain

158. Oral Clonidine Premedication Attenuates Hemodynamic Responses of Ketamine during Total Intravenous Anesthesia. Full Text available with Trip Pro

Oral Clonidine Premedication Attenuates Hemodynamic Responses of Ketamine during Total Intravenous Anesthesia. The most commonly used drug for total intravenous anesthesia (TIVA) is ketamine which results in cardiovascular stimulation.The primary aim of this study was to assess the effect of oral clonidine premedication on attenuating the hemodynamic responses following ketamine administration.This was a prospective, observational, comparative study conducted in a tertiary care institution.A (...) total of 40 female patients aged 18-55 years who were posted for elective short gynecological procedures under TIVA were recruited for this study. Group A patients were given oral clonidine 150 μg 60 min before proposed surgical procedure, whereas Group B patients received a placebo tablet. Before induction, all patients received glycopyrrolate 0.2 mg, midazolam 2 mg, and fentanyl 2 μg/kg intravenously. Anesthesia was induced with ketamine 1.5 mg/kg body weight intravenously over 2-3 min

2019 Anesthesia, essays and researches Controlled trial quality: uncertain

159. Does Sub-Anesthetic Ketamine Provide Postoperative Analgesia for Third Molar Surgery? (Abstract)

Does Sub-Anesthetic Ketamine Provide Postoperative Analgesia for Third Molar Surgery? Despite ketamine's effectiveness as an anesthetic and its known analgesic properties, the role of ketamine in postoperative pain after third molar surgery remains unclear. Therefore, this study aimed to investigate whether patients undergoing third molar surgery who received a sub-anesthetic preoperative dose of intravenous ketamine would experience less postoperative pain.We implemented a randomized, double (...) -blinded, placebo-controlled trial. The study sample consisted of participants undergoing third molar surgery with procedural sedation anesthesia. Participants were randomized to receive a preoperative intravenous dose of ketamine or placebo, as predictor variables. The primary outcome variable was postoperative pain intensity determined by a 10-point visual analog scale at 6-hour intervals over a period of 48 hours. The secondary outcome variable was the quantity of postoperative non-opioid and opioid

2019 Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons Controlled trial quality: predicted high

160. Procedural Sedation Using a Propofol-Ketamine Combination (Ketofol) vs. Propofol Alone in the Loop Electrosurgical Excision Procedure (LEEP): A Randomized Controlled Trial. Full Text available with Trip Pro

Procedural Sedation Using a Propofol-Ketamine Combination (Ketofol) vs. Propofol Alone in the Loop Electrosurgical Excision Procedure (LEEP): A Randomized Controlled Trial. Although the loop electrosurgical excision procedure (LEEP) is a brief procedure, it can cause severe pain and discomfort to patients in the absence of adequate sedation. An admixture of ketamine with propofol (ketofol), may reduce patient movement due to insufficient sedation while providing hemodynamic and respiratory (...) stability. This study evaluated the ability of two ratios of a propofol-ketamine combination, compared with propofol alone, to reduce patient movement during procedural sedation for LEEPs.One hundred and twenty women scheduled for a LEEP were randomly assigned to three groups. Anesthesia was induced with 1 mg/kg propofol (group P), 1 mg/kg propofol and 0.33 mg/kg ketamine (group K1), or 1 mg/kg propofol and 0.66 mg/kg ketamine (group K2). The primary outcome was the incidence of adduction motion

2019 Journal of clinical medicine Controlled trial quality: uncertain

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