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Ketamine

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161. Safety of Intranasal Ketamine for Reducing Uncontrolled Cancer-Related Pain: Protocol of a Phase I/II Clinical Trial. Full Text available with Trip Pro

Safety of Intranasal Ketamine for Reducing Uncontrolled Cancer-Related Pain: Protocol of a Phase I/II Clinical Trial. Approximately 12 million Americans are affected with cancer. Of these, 53% experience pain at all stages of cancer. Pain may remain uncontrolled despite high-dose opioid therapy, and opioids have many well-documented harmful side effects. Intranasal ketamine has been shown to be effective in controlling breakthrough noncancer pain in a double-blind randomized control trial (...) (DBRCT) by Carr et al in 2003 as well as to help with depression in a DBRCT by Lapidus et al in 2014. We seek to obtain preliminary data on the safety, feasibility, and utility of this novel technique for the treatment of uncontrolled cancer pain.This study aimed to obtain preliminary data via a clinical trial addressing the safety, feasibility, pharmacokinetics, and pharmacodynamics of intranasal ketamine. These initial findings will be applied to a subsequent trial to determine the effectiveness

2019 JMIR Research Protocols Controlled trial quality: uncertain

162. Ketamine infusion for pain control in elderly patients with multiple rib fractures: Results of a randomized controlled trial. (Abstract)

Ketamine infusion for pain control in elderly patients with multiple rib fractures: Results of a randomized controlled trial. Rib fractures are associated with increased mortality, particularly in the elderly. While opiate-based pain regimens remain the cornerstone of rib fracture management, issues related to opioids have driven research into alternative analgesics. Adjunctive ketamine use in lieu of opioids continues to increase but little evidence exists to support its efficacy or safety (...) within the elderly trauma population.A prospective, randomized, double-blind placebo-controlled trial of elderly patients (age, ≥65 years) with three or more rib fractures admitted to a Level I trauma center was conducted. Exclusion criteria included Glasgow Coma Scale score less than 14, and chronic opiate use. Groups were randomized to either low-dose ketamine (LDK) at 2 μg·kg·min or an equivalent rate of 0.9% normal saline. The primary outcome was reduction in numeric pain scores (NPS). Secondary

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

163. Effect of different doses of ketamine with low-dose rocuronium on intubation conditions in children: prospective randomized double blind trial. (Abstract)

Effect of different doses of ketamine with low-dose rocuronium on intubation conditions in children: prospective randomized double blind trial. The effect of ketamine on intubation condition, when used as an induction agent with low-dose rocuronium, is unknown. This study aimed to compare the effects of three doses of ketamine used with 0.3 mg/kg rocuronium and 1 µg/kg fentanyl on intubation conditions in children undergoing short elective surgery.The study was performed as a prospective (...) , randomized double-blind clinical trial. A total of 60 children aged 2 to 12 years, who were scheduled for inguinal herniorrhaphy under general anesthesia, were randomly allocated into three groups on the basis of ketamine dose: 1 mg/kg (Group K1, n = 20), 1.5 mg/kg (Group K1.5, n = 20), and 2 mg/kg (Group K2, n = 20). The primary outcome was the intubation condition. Other assessments included hemodynamic data, recovery profile, adverse events in the postanesthetic care unit (PACU) and use of fentanyl

2019 European review for medical and pharmacological sciences Controlled trial quality: predicted high

164. KETAMINE AS A POSSIBLE MODERATOR OF HYPNOTIZABILITY: A FEASIBILITY STUDY. Full Text available with Trip Pro

KETAMINE AS A POSSIBLE MODERATOR OF HYPNOTIZABILITY: A FEASIBILITY STUDY. This pilot study explored the feasibility of using ketamine to increase hypnotizability scores. Ketamine, classified as a dissociative hallucinogen, is used clinically as an anesthetic in high doses and as a treatment for chronic pain and depression in lower doses. Low-dose ketamine can contribute to dissociation and heightened perceptions and feelings of detachment, arguably hypnotic-like states. The authors predicted (...) that a low dose of ketamine in healthy volunteers who scored in the low hypnotizable range on the Stanford Clinical Hypnotizability Scale would (a) cause an increase in subjective ratings of dissociation and (b) lead to an increase in hypnotizability. The findings were in the predicted direction, warranting further investigation into the use of this agent to increase hypnotizability.

2019 The International journal of clinical and experimental hypnosis Controlled trial quality: uncertain

165. Comparison of Topical and Subcutaneous Bupivacaine Infiltration with Subcutaneous Ketamine on Postoperative Pain in Total Abdominal Hysterectomy. Full Text available with Trip Pro

Comparison of Topical and Subcutaneous Bupivacaine Infiltration with Subcutaneous Ketamine on Postoperative Pain in Total Abdominal Hysterectomy. Hysterectomy is one of the most common surgical procedures. Problems such as severe pelvic pain, irregular or heavy bleeding and uterine cancer from those that may be used to treat them no choice but to remove the uterus by surgery. Abdominal pain after abdominal hysterectomy, the most common complaints of patients undergoing this type of surgery (...) is considered.This study aimed to compare the effects of bupivacaine into the subcutaneous tissue and skin ketamine for pain control after surgery in patients undergoing abdominal hysterectomy was performed under general anesthesia.This study is a randomized, double-blind clinical trial involving 99 women scheduled for TAH referred to tertiary centers was performed. Group A: 5 mL of 0.25% bupivacaine into the subcutaneous tissue and, Group II: 100 mg ketamine skin and subcutaneous tissue with cc5 volume

2019 Medical archives (Sarajevo, Bosnia and Herzegovina) Controlled trial quality: uncertain

166. Effects of injectable dexmedetomidine-ketamine-midazolam and isoflurane inhalation anesthetic protocols on ocular variables in captive black-tailed prairie dogs ( (Abstract)

Effects of injectable dexmedetomidine-ketamine-midazolam and isoflurane inhalation anesthetic protocols on ocular variables in captive black-tailed prairie dogs ( To evaluate the effects of injectable dexmedetomidine-ketamine-midazolam (DKM) and isoflurane inhalation (ISO) anesthetic protocols on selected ocular variables in captive black-tailed prairie dogs (Cynomys ludovicianus; BTPDs).9 zoo-kept BTPDs.The BTPDs received dexmedetomidine hydrochloride (0.25 mg/kg, IM), ketamine hydrochloride

2019 American journal of veterinary research Controlled trial quality: uncertain

167. Attenuation of antidepressant and antisuicidal effects of ketamine by opioid receptor antagonism. (Abstract)

Attenuation of antidepressant and antisuicidal effects of ketamine by opioid receptor antagonism. We recently reported that naltrexone blocks antidepressant effects of ketamine in humans, indicating that antidepressant effects of ketamine require opioid receptor activation. However, it is unknown if opioid receptors are also involved in ketamine's antisuicidality effects. Here, in a secondary analysis of our recent clinical trial, we test whether naltrexone attenuates antisuicidality effects (...) of ketamine. Participants were pretreated with naltrexone or placebo prior to intravenous ketamine in a double-blinded crossover design. Suicidality was measured with the Hamilton Depression Rating Scale item 3, Montgomery-Åsberg Depression Rating Scale item 10, and Columbia Suicide Severity Rating Scale. In the 12 participants who completed naltrexone and placebo conditions, naltrexone attenuated the antisuicidality effects of ketamine on all three suicidality scales/subscales (linear mixed model, fixed

2019 Molecular psychiatry Controlled trial quality: uncertain

168. Preoperative ketamine nebulization attenuates the incidence and severity of postoperative sore throat: A randomized controlled clinical trial. Full Text available with Trip Pro

Preoperative ketamine nebulization attenuates the incidence and severity of postoperative sore throat: A randomized controlled clinical trial. Endotracheal intubation is the prominent cause of airway mucosal injury which results in postoperative sore throat (POST), with an incidence of 21%-65%. Although this complication is minor, if left unresolved, it produces significant agony and annoyance to the patient. This study was conducted to evaluate the efficacy of nebulized ketamine in decreasing (...) POST.After written informed consent, 96 patients of the American Society of Anesthesiologists physical status (PS) 1-2 between 18 and 60 years, of either sex undergoing general anesthesia (GA) with tracheal intubation were enrolled in this prospective, randomized, placebo-control, and double-blind controlled trial. Patients were randomized into two groups; Group 1 received ketamine 50 mg (1.0 ml) with 4.0 ml of saline nebulization, while Group 2 received saline nebulization 5.0 ml for 15 min. GA

2019 Saudi journal of anaesthesia Controlled trial quality: predicted high

169. Topical versus caudal ketamine/bupivacaine combination for postoperative analgesia in children undergoing inguinal herniotomy. Full Text available with Trip Pro

Topical versus caudal ketamine/bupivacaine combination for postoperative analgesia in children undergoing inguinal herniotomy. Multiple studies claim that caudal administration of ketamine causes effective postoperative analgesia. The aim of this study was to assess the clinical effectiveness of ketamine after caudal or topical administration in pediatric patients undergoing inguinal herniotomy.This randomized, comparative, double-blind study included eighty children (aged 6 months to 6 years (...) ) received either 1 ml/kg of 0.25% bupivacaine/ketamine 0.5 mg/kg for caudal analgesia (caudal group) or 0.3 ml/kg of 0.25% bupivacaine/ketamine 0.5 mg/kg sprayed by the surgeon around the spermatic cord and upon the ilioinguinal nerve before wound closure for topical analgesia (topical group). The duration of postoperative analgesia, pain scores, rescue analgesic consumption, sedation score, hemodynamic monitoring, and side-effects were evaluated 48 h postoperative.Kaplan-Meier survival analysis

2019 Saudi journal of anaesthesia Controlled trial quality: uncertain

170. Effects of atipamezole dosage and timing of administration on recovery time and quality in cats following injectable anaesthesia incorporating ketamine. (Abstract)

Effects of atipamezole dosage and timing of administration on recovery time and quality in cats following injectable anaesthesia incorporating ketamine. The aim of this study was to establish the optimum dosage and timing of administration of atipamezole in cats undergoing general anaesthesia incorporating ketamine to provide the shortest recovery possible without unacceptably compromising recovery quality.In total, 128 healthy male cats (age range 2-108 months, weight range 0.56-5.22 kg (...) ) admitted for castration were randomly allocated to groups of 32. Anaesthesia was induced with 60 mg/m2 ketamine, 180 µg/m2 buprenorphine, 3 mg/m2 midazolam and 600 µg/m2 medetomidine intramuscularly (IM). Cats received 600 µg/m2 (groups 1ATI20 and 1ATI40) or 1.5 mg/m2 (groups 2.5ATI20 and 2.5ATI40) atipamezole IM either 20 (groups 1ATI20 and 2.5ATI20) or 40 mins (groups 1ATI40 and 2.5ATI40) after the 'quad'. Preparation time, surgical time, auricular temperature, times to sternal recumbency and first

2019 Journal of feline medicine and surgery Controlled trial quality: uncertain

171. Comparison of intranasal midazolam, intranasal ketamine, and oral chloral hydrate for conscious sedation during paediatric echocardiography: results of a prospective randomised study. (Abstract)

Comparison of intranasal midazolam, intranasal ketamine, and oral chloral hydrate for conscious sedation during paediatric echocardiography: results of a prospective randomised study. There are several agents used for conscious sedation by various routes in children. The aim of this prospective randomised study is to compare the effectiveness of three commonly used sedatives: intranasal ketamine, intranasal midazolam, and oral chloral hydrate for children undergoing transthoracic (...) echocardiography.Children who were referred to paediatric cardiology due to a heart murmur for transthoracic echocardiography were prospectively randomised into three groups. Seventy-three children received intranasal midazolam (0.2 mg/kg), 72 children received intranasal ketamine (4 mg/kg), and 72 children received oral chloral hydrate (50 mg/kg) for conscious sedation. The effects of three agents were evaluated in terms of intensity, onset, and duration of sedation. Obtaining high-quality transthoracic

2019 Cardiology in the young Controlled trial quality: uncertain

172. Ketamine metabolite pilot study in a suicidal depression trial. (Abstract)

Ketamine metabolite pilot study in a suicidal depression trial. Ketamine shows promise as a rapidly-acting treatment for depression and suicidal ideation, but side effects and abuse potential limit its use. Understanding its mechanism of action could help develop analogous but safer drugs. This post hoc study explored relationships of ketamine and metabolites, including hydroxynorketamine enantiomers, (2S,6S)- and (2R,6R)-HNK, to clinical response in a subgroup from a published trial (...) in suicidal depression. Depressed adults with clinically significant suicidal ideation were randomized to double-blind infusion of sub-anesthetic ketamine or midazolam. Ketamine and metabolites were measured after infusion (N = 53). Plasma (2R,6R)-HNK was associated with change (higher levels correlated with less clinical improvement) from baseline to 24 h post-infusion of depression (HDRS-24: Spearman r = 0.37, p = 0.009) and suicidal thoughts (SSI: Spearman r = 0.29, p = 0.041). There were similar

2019 Journal of psychiatric research Controlled trial quality: uncertain

173. Prophylactic use of ketamine reduces postpartum depression in Chinese women undergoing cesarean section (Abstract)

Prophylactic use of ketamine reduces postpartum depression in Chinese women undergoing cesarean section This study aimed to explore the effect of prophylactic ketamine administration on postpartum depression in Chinese woman undergoing cesarean section. This randomized controlled study included 654 Chinese women undergoing cesarean section. At 10 min after child birth, patients in the ketamine group were given 0.5 mg/kg ketamine, whereas patients in the control group received standard (...) postpartum care. At the end of operation, all patients were armed with a patient-controlled intravenous analgesia device. The primary outcome was the prevalence of postpartum depression (PPD), as assessed by the Edinburgh Postnatal Depression Scale (EPDS), and the secondary outcomes included the safety assessment and the Numerical Rating Scale (NRS) of postoperative pain. The prevalence of postpartum blues and postpartum depression were significantly lower in the ketamine group than in the control group

2019 Psychiatry research Controlled trial quality: uncertain

174. Low-dose ketamine in painful orthopaedic surgery: a systematic review and meta-analysis. Full Text available with Trip Pro

Low-dose ketamine in painful orthopaedic surgery: a systematic review and meta-analysis. Ketamine is a phencyclidine intravenous anaesthetic that blocks N-methyl-d-aspartate receptors and HCN channels in the CNS. Lately it has gained acceptance in a low-dose form, with studies showing an analgesic benefit in orthopaedic surgery. Our goal was to critically appraise and synthesise current evidence regarding use of low-dose ketamine in major, painful orthopaedic surgeries.We conducted searches (...) in Medline, Embase, Cochrane, and specialty journals for randomised controlled trials (RCTs) that compared low-dose ketamine to placebo. Primary outcomes included total opioid use, time to first opioid, and VAS pain scores. Meta-analyses were undertaken in RevMan software using a random effects model. We rated the quality of the evidence using the GRADE Working Group criteria.We included 20 studies across four subgroups for meta-analysis. The overall quality of the evidence was moderate. Ketamine

2019 British Journal of Anaesthesia

175. Electroencephalographic slow wave dynamics and loss of behavioural responsiveness induced by ketamine in human volunteers. Full Text available with Trip Pro

Electroencephalographic slow wave dynamics and loss of behavioural responsiveness induced by ketamine in human volunteers. Previous work on the electroencephalographic (EEG) effects of anaesthetic doses of ketamine has identified a characteristic signature of increased high frequency (beta-gamma) and theta waves alternating with episodic slow waves. It is unclear which EEG parameter is optimal for pharmacokinetic-pharmacodynamic modelling of the hypnotic actions of ketamine, or which EEG (...) parameter is most closely linked to loss of behavioural responsiveness.We re-analysed previously published 128-channel scalp EEG data from 15 subjects who had received a 1.5 mg kg-1 bolus i.v. dose of ketamine. We applied standard sigmoid pharmacokinetic-pharmacodynamic models to the drug-induced changes in slow wave activity, theta, and beta-gamma EEG power; and examined the morphology of the slow waves in the time domain for Fz, F3, T3, P3, and Pz average-referenced channels.Hypnotic doses of ketamine

2019 British Journal of Anaesthesia

176. Subanesthetic ketamine infusions for the management of pediatric pain in non-critical care settings: An observational analysis. (Abstract)

Subanesthetic ketamine infusions for the management of pediatric pain in non-critical care settings: An observational analysis. Guidelines issued by the American Society of Regional Anesthesia and Pain Medicine suggest that ketamine infusions for acute pain management are advantageous as a primary treatment or as an opioid adjunct. Despite significant data regarding its use in adult patients, there remains a paucity of information related to its quality and side effect profile in pediatrics (...) and how it can be effectively used. We aimed to summarize our practice of utilizing ketamine for pediatric pain management in non-critical care settings.Patients aged 0-21 years receiving low-dose ketamine infusions (≤0.3 mg/kg/hour) in inpatient care units over five years were retrospectively analyzed. Demographics, specific quality metrics, and side effects were quantified.About 172 patients received 270 subhypnotic ketamine infusions. The median duration of the infusions was 63.8 hours and 0.2 mg

2019 Acta Anaesthesiologica Scandinavica

177. Ketamine Administration During Hospitalization Is Not Associated With Posttraumatic Stress Disorder Outcomes in Military Combat Casualties: A Matched Cohort Study. (Abstract)

Ketamine Administration During Hospitalization Is Not Associated With Posttraumatic Stress Disorder Outcomes in Military Combat Casualties: A Matched Cohort Study. Ketamine is routinely used within the context of combat casualty care. Despite early concerns that ketamine administration may be associated with elevated risk of posttraumatic stress disorder (PTSD), more recent evidence suggests no relationship. Because PTSD occurs with regular frequency in Operation Iraqi Freedom/Operation (...) Enduring Freedom (OIF/OEF) Service Members (SMs) and combat-related injuries are associated with higher likelihood of PTSD, it is important to investigate the relationship between ketamine exposure during inpatient medical and surgical care and PTSD symptoms in OIF/OEF SMs.Medical record data from OIF/OEF SMs medically evacuated from combat (N = 1158) included demographic characteristics, injury severity, body areas injured, and PTSD Checklist (PCL) scores. The primary analysis assessed the association

2019 Anesthesia and Analgesia

178. Welfare and pregnancy rate of ewes undergoing transcervical artificial insemination with ketamine subarachnoid anesthesia. (Abstract)

Welfare and pregnancy rate of ewes undergoing transcervical artificial insemination with ketamine subarachnoid anesthesia. This study aimed to evaluate the impact of subarachnoid anesthesia with ketamine during transcervical artificial insemination (TCAI) on the welfare of ewes and on subsequent pregnancy rates. Ninety Suffolk adult ewes were randomized into three treatment groups: control group (CG), which underwent the TCAI procedure as established by cervical traction (CG; n = 30) and two (...) groups that received subarachnoid anesthesia with ketamine at a dose of either 0.75 mg/kg (KE0.75; n = 30) or 1.5 mg/kg (KE1.5; n = 30) 5 min before the cervical traction procedure. Intrauterine insemination was performed using frozen semen from three males previously analyzed and approved for fertility. The use of subarachnoid anesthesia decreased ewes' vocalizations (P = 0.0001) and abdominal contraction (P = 0.0150) during cervical manipulations. The CG had more groans and vocalizations

2019 Tropical animal health and production

179. Challenges in Testing Intranasal Ketamine in Obsessive-Compulsive Disorder. Full Text available with Trip Pro

Challenges in Testing Intranasal Ketamine in Obsessive-Compulsive Disorder. 28448699 2019 01 04 2019 01 04 1555-2101 78 4 2017 04 The Journal of clinical psychiatry J Clin Psychiatry Challenges in Testing Intranasal Ketamine in Obsessive-Compulsive Disorder. 466-467 10.4088/JCP.16cr11234 Rodriguez Carolyn I CI cr2163@stanford.edu. Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA. Veterans Affairs Palo Alto Health Care System, Palo Alto, California (...) States J Clin Psychiatry 7801243 0160-6689 0 Excitatory Amino Acid Antagonists 690G0D6V8H Ketamine IM Administration, Intranasal Adolescent Adult Drug Administration Schedule Excitatory Amino Acid Antagonists administration & dosage therapeutic use Female Humans Ketamine administration & dosage therapeutic use Male Middle Aged Obsessive-Compulsive Disorder drug therapy Treatment Outcome Young Adult 2017 4 28 6 0 2017 4 28 6 0 2019 1 5 6 0 ppublish 28448699 10.4088/JCP.16cr11234

2019 The Journal of clinical psychiatry Controlled trial quality: uncertain

180. Ketamine infusion for pain control in adult patients with multiple rib fractures: Results of a randomized control trial. (Abstract)

Ketamine infusion for pain control in adult patients with multiple rib fractures: Results of a randomized control trial. Rib fractures occur in up to 40% of trauma patients and are associated with increased mortality. Opiate-based pain regimens remain the cornerstone of rib fracture management; however, concerns around opioids have fostered interest in alternative analgesics. Ketamine is currently being used in lieu of opioids, but little evidence exists supporting its use within the trauma (...) population.A prospective, randomized, double-blind placebo-controlled trial of adult patients with three or more rib fractures admitted to a Level I trauma center was conducted. Exclusion criteria included age older than 64 years, Glasgow Coma Scale score less than 13, and chronic opiate use. The experimental arm received low-dose ketamine (LDK) at 2.5 μg·kg·min while the placebo cohort received an equivalent rate of 0.9% normal saline. All infusions were continued for 48 hours. The primary outcome

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

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