Latest & greatest articles for ketamine

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Top results for ketamine

61. Preemptive analgesic effect of ketamine in patients undergoing elective cesarean section

Preemptive analgesic effect of ketamine in patients undergoing elective cesarean section 20173436 2010 02 22 2010 05 13 2013 11 21 1536-5409 26 3 2010 Mar-Apr The Clinical journal of pain Clin J Pain Preemptive analgesic effect of ketamine in patients undergoing elective cesarean section. 223-6 10.1097/AJP.0b013e3181bff86d In this study, the preemptive effect of a small dose of ketamine on postoperative wound pain and morphine consumption in patients undergoing elective cesarean section (...) was evaluated. In a randomized, double-blind clinical trial, 60 women with American Society of Anesthesiologists class I and II identification undergoing elective cesarean section were enrolled. In the case group, the patients received 0.5 mg/kg ketamine, and in the control group, they received isotonic saline, 5 minutes before the induction of anesthesia. Anesthesia was induced with 4 mg/kg thiopental followed by 1.5 mg/kg succinylcholine. A further neuromuscular block was achieved by using 0.2 mg/kg

EvidenceUpdates2010

62. The early and delayed analgesic effects of ketamine after total hip arthroplasty: a prospective, randomized, controlled, double-blind study

The early and delayed analgesic effects of ketamine after total hip arthroplasty: a prospective, randomized, controlled, double-blind study 19923527 2009 11 20 2009 12 03 2013 11 21 1526-7598 109 6 2009 Dec Anesthesia and analgesia Anesth. Analg. The early and delayed analgesic effects of ketamine after total hip arthroplasty: a prospective, randomized, controlled, double-blind study. 1963-71 10.1213/ANE.0b013e3181bdc8a0 Ketamine has been shown to have a morphine-sparing effect soon after (...) surgery. Nevertheless, whether this effect still exists after being combined with nonsteroidal antiinflammatory drugs and acetaminophen, and whether ketamine can decrease chronic pain after nononcologic surgery remain unclear. Thus, we designed a study to assess ketamine's effect on acute and chronic postoperative pain when combined with multimodal analgesia after total hip arthroplasty (THA). Patients scheduled for primary nononcologic THA using standardized general anesthesia were randomized

EvidenceUpdates2010

63. Ketamine produces effective and long-term pain relief in patients with Complex Regional Pain Syndrome Type 1

Ketamine produces effective and long-term pain relief in patients with Complex Regional Pain Syndrome Type 1 19604642 2009 09 11 2009 12 07 2013 11 21 1872-6623 145 3 2009 Oct Pain Pain Ketamine produces effective and long-term pain relief in patients with Complex Regional Pain Syndrome Type 1. 304-11 10.1016/j.pain.2009.06.023 Complex Regional Pain Syndrome Type 1 (CRPS-1) responds poorly to standard pain treatment. We evaluated if the N-methyl-D-aspartate receptor antagonist S(+)-ketamine (...) improves pain in CRPS-1 patients. Sixty CRPS-1 patients (48 females) with severe pain participated in a double-blind randomized placebo-controlled parallel-group trial. Patients were given a 4.2-day intravenous infusion of low-dose ketamine (n=30) or placebo (n=30) using an individualized stepwise tailoring of dosage based on effect (pain relief) and side effects (nausea/vomiting/psychomimetic effects). The primary outcome of the study was the pain score (numerical rating score: 0-10) during the 12

EvidenceUpdates2010

64. Postoperative analgesia and early rehabilitation after total knee replacement: a comparison of continuous low-dose intravenous ketamine versus nefopam

Postoperative analgesia and early rehabilitation after total knee replacement: a comparison of continuous low-dose intravenous ketamine versus nefopam 18793861 2009 06 09 2009 08 12 2013 11 21 1532-2149 13 6 2009 Jul European journal of pain (London, England) Eur J Pain Postoperative analgesia and early rehabilitation after total knee replacement: a comparison of continuous low-dose intravenous ketamine versus nefopam. 613-9 10.1016/j.ejpain.2008.08.003 The effects of nefopam and ketamine (...) on pain control and rehabilitation after total knee replacement were compared in a prospective, double blinded study. Seventy-five patients were randomly assigned to receive a 0.2mg kg(-1) bolus of nefopam or ketamine, followed by a 120microg kg(-1) h(-1) continuous infusion until the end of surgery, and 60microg kg(-1) h(-1) until the second postoperative day, or an equal volume of saline considered as placebo. Pain scores measured on a visual analog scale at rest and on mobilization, and patient

EvidenceUpdates2009

65. Morphine with adjuvant ketamine vs. Higher doses of morphine alone for immediate post-thoracotomy analgesia

Morphine with adjuvant ketamine vs. Higher doses of morphine alone for immediate post-thoracotomy analgesia 18753471 2009 07 08 2009 08 05 2014 07 30 1931-3543 136 1 2009 Jul Chest Chest Morphine with adjuvant ketamine vs higher dose of morphine alone for immediate postthoracotomy analgesia. 245-52 10.1378/chest.08-0246 Thoracotomy is associated with severe pain. We hypothesized that the concomitant use of a subanesthetic dose of ketamine plus a two-third-standard morphine dose might provide (...) solution (MO) or 1.0 mg of morphine plus a 5-mg ketamine bolus (MK), with a 7-min lockout time. Rescue IM diclofenac, 75 mg, was available. Follow-up lasted 4 h. Forty-one patients completed the study. MO patients (n = 20) used 6.8 +/- 1.9 mg/h (mean +/- SD) and 5.5 +/- 3.6 mg/h of morphine during the first and second hours, respectively; MK patients (n = 21) used 3.7 +/- 1.2 mg/h and 2.8 +/- 2.3 mg/h, respectively (p < 0.01). The 4-h activation rate of the device was double in the MO patients than

EvidenceUpdates2009

66. Ketamine and lornoxicam for preventing a fentanyl-induced increase in postoperative morphine requirement

Ketamine and lornoxicam for preventing a fentanyl-induced increase in postoperative morphine requirement 19020155 2008 11 21 2008 12 30 2013 11 21 1526-7598 107 6 2008 Dec Anesthesia and analgesia Anesth. Analg. Ketamine and lornoxicam for preventing a fentanyl-induced increase in postoperative morphine requirement. 2032-7 10.1213/ane.0b013e3181888061 N-methyl-D-aspartate receptor antagonists and nonsteroidal anti-inflammatory drugs are believed to prevent opioid-induced hyperalgesia (...) and/or acute opioid tolerance, which could cause an increase in postoperative opioid requirement. In this randomized, double-blind, placebo-controlled study, we investigated whether co-administration of ketamine or lornoxicam and fentanyl could prevent the increase of postoperative morphine requirement induced by fentanyl alone. Ninety females undergoing total abdominal hysterectomy with spinal anesthesia were randomly assigned to six groups consisting of placebo (normal saline, C), fentanyl (three bolus

EvidenceUpdates2009

67. Predictors of airway and respiratory adverse events with ketamine sedation in the emergency department: an individual-patient data meta-analysis of 8,282 children

Predictors of airway and respiratory adverse events with ketamine sedation in the emergency department: an individual-patient data meta-analysis of 8,282 children Predictors of airway and respiratory adverse events with ketamine sedation in the emergency department: an individual-patient data meta-analysis of 8,282 children Predictors of airway and respiratory adverse events with ketamine sedation in the emergency department: an individual-patient data meta-analysis of 8,282 children Green SM (...) , Roback MG, Krauss B, Brown L, McGlone RG, Agrawal D, McKee M, Weiss M, Pitetti RD, Hostetler MA, Wathen JE, Treston G, Garcia Pena BM, Gerber AC, Losek JD, Emergency Department Ketamine Meta-Analysis Study Group CRD summary This review concluded that patients sedated with ketamine were at higher risk of airway and respiratory adverse events if they were younger than 21 years, or if physicians used co-administered anticholinergics or benzodiazepines. The quality and variability of raw data

DARE.2009

68. Predictors of emesis and recovery agitation with emergency department ketamine sedation: an individual-patient data meta-analysis of 8,282 children

Predictors of emesis and recovery agitation with emergency department ketamine sedation: an individual-patient data meta-analysis of 8,282 children Predictors of emesis and recovery agitation with emergency department ketamine sedation: an individual-patient data meta-analysis of 8,282 children Predictors of emesis and recovery agitation with emergency department ketamine sedation: an individual-patient data meta-analysis of 8,282 children Green SM, Roback MG, Krauss B, Brown L, McGlone RG (...) , Agrawal D, McKee M, Weiss M, Pitetti RD, Hostetler MA, Wathen JE, Treston G, Garcia Pena BM, Gerber AC, Losek JD, Emergency Department Ketamine Meta-Analysis Study Group CRD summary This individual patient analysis suggested that there might be a higher risk of emesis for patients sedated with ketamine if they were young adolescents or physicians used an initial dose of ≥2.5mg/kg or total dose of ≥5mg/kg. Low quality variable raw data and potential biases from the search and analytical methods caused

DARE.2009

69. Pharmacological Dental Anxiety Management with Ketamine and Midazolam in Uncooperative Children

Pharmacological Dental Anxiety Management with Ketamine and Midazolam in Uncooperative Children UTCAT447, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Pharmacological Dental Anxiety Management with Ketamine and Midazolam in Uncooperative Children Clinical Question In young uncooperative children, will ketamine be more effective than midazolam in reducing dental anxiety? Clinical Bottom Line The benzodiazepine (...) midazolam was more effective than ketamine in reducing dental anxiety in young uncooperative children. (See Comments on the CAT below) Best Evidence (you may view more info by clicking on the PubMed ID link) PubMed ID Author / Year Patient Group Study type (level of evidence) #1) Damle/2008 Uncooperative children 2-6 years of age. Randomized Controlled Trial Key results Dental anxiety was lower with the use of ketamine than with midazolam. Heart rate and respiratory rate were marginally higher

UTHSCSA Dental School CAT Library2009

70. Etomidate versus ketamine for rapid sequence intubation in acutely ill patients: a multicentre randomised controlled trial.

Etomidate versus ketamine for rapid sequence intubation in acutely ill patients: a multicentre randomised controlled trial. 19573904 2009 07 27 2009 08 07 2016 07 20 1474-547X 374 9686 2009 Jul 25 Lancet (London, England) Lancet Etomidate versus ketamine for rapid sequence intubation in acutely ill patients: a multicentre randomised controlled trial. 293-300 10.1016/S0140-6736(09)60949-1 Critically ill patients often require emergency intubation. The use of etomidate as the sedative agent (...) in this context has been challenged because it might cause a reversible adrenal insufficiency, potentially associated with increased in-hospital morbidity. We compared early and 28-day morbidity after a single dose of etomidate or ketamine used for emergency endotracheal intubation of critically ill patients. In this randomised, controlled, single-blind trial, 655 patients who needed sedation for emergency intubation were prospectively enrolled from 12 emergency medical services or emergency departments

Lancet2009

71. Subdissociative-dose ketamine versus fentanyl for analgesia during propofol procedural sedation: a randomized clinical trial

Subdissociative-dose ketamine versus fentanyl for analgesia during propofol procedural sedation: a randomized clinical trial 18754820 2008 10 14 2008 12 16 2013 11 21 1553-2712 15 10 2008 Oct Academic emergency medicine : official journal of the Society for Academic Emergency Medicine Acad Emerg Med Subdissociative-dose ketamine versus fentanyl for analgesia during propofol procedural sedation: a randomized clinical trial. 877-86 10.1111/j.1553-2712.2008.00219.x The authors sought to compare (...) the safety and efficacy of subdissociative-dose ketamine versus fentanyl as adjunct analgesics for emergency department (ED) procedural sedation and analgesia (PSA) with propofol. This double-blind, randomized trial enrolled American Society of Anesthesiology (ASA) Class I or II ED patients, aged 14-65 years, requiring PSA for orthopedic reduction or abscess drainage. Subjects received 0.3 mg/kg ketamine or 1.5 mug/kg fentanyl intravenously (IV), followed by IV propofol titrated to deep sedation

EvidenceUpdates2008

72. Does the time of fasting affect complication rates during ketamine sedation

Does the time of fasting affect complication rates during ketamine sedation BestBets: Does the time of fasting affect complication rates during ketamine sedation Does the time of fasting affect complication rates during ketamine sedation Report By: Ray McGlone - Consultant in Emergency Medicine Search checked by Simon Carley - Consultant in Emergency Medicine Institution: Lancaster Royal Infirmary Original author: Ray McGlone Original institution: Lancaster Royal Infirmary Current web editor (...) : Tom Bartram - middle grade A+E Date Submitted: 4th March 2005 Last Modified: 14th August 2008 Status: Green (complete) Three Part Question [In children undergoing ketamine sedation] is [prolonged fasting (6 hours or more) better than short term fasting (3 hours)] at [reducing the incidence of vomiting and other complications of sedation] Clinical Scenario A 4 year old boy is brought to the emergency department having fallen over at home. He has sustained a 3 cm deep laceration to the forehead. He

BestBETS2008

73. Is atropine needed as an adjunct in paediatric ketamine administration?

Is atropine needed as an adjunct in paediatric ketamine administration? BestBets: Is atropine needed as an adjunct in paediatric ketamine administration? Is atropine needed as an adjunct in paediatric ketamine administration? Report By: Simon Carley - Consultant in Emergency Medicine Search checked by Rick Body - Specialist Registrar in Emergency Medicine Institution: Manchester Royal Infirmary Date Submitted: 20th February 2007 Last Modified: 14th August 2008 Status: Green (complete) Three (...) Part Question [In children requiring procedural sedation with ketamine] does [the coadministration of atropine] alter [salivation, safety, vomiting, recovery time and/or effectiveness] Clinical Scenario A 4 year old patient presents to the ED with a lip laceration, you decide to repair it under ketamine sedation and prepare an appropriate dose of ketamine and atropine. However, before administration your colleague (who has recently returned from Australia) tells you that it is a waste of time

BestBETS2008

74. Effects of intra-articular ketamine on pain and somatosensory function in temporomandibular joint arthralgia patients

Effects of intra-articular ketamine on pain and somatosensory function in temporomandibular joint arthralgia patients 17923328 2008 06 30 2008 09 18 2013 11 21 1872-6623 137 2 2008 Jul 15 Pain Pain Effects of intra-articular ketamine on pain and somatosensory function in temporomandibular joint arthralgia patients. 286-94 Recent studies have hypothesized that peripheral glutamate receptors could be implicated in deep craniofacial pain conditions. In this study 18 temporomandibular joint (TMJ (...) ) arthralgia patients received intra-articular injections of the N-methyl-D-aspartate (NMDA) receptor antagonist, ketamine, or normal saline to study in a cross-over, double-blinded, placebo-controlled manner the effect on TMJ pain and somatosensory function. Spontaneous pain and pain on jaw function was scored by patients on 0-10 cm visual analogue scale (VAS) for up to 24h. Quantitative sensory tests (QST): tactile, pin-prick, pressure pain threshold and pressure pain tolerance were used for assessment

EvidenceUpdates2008

75. Postoperative ketamine administration decreases morphine consumption in major abdominal surgery: a prospective, randomized, double-blind, controlled study

Postoperative ketamine administration decreases morphine consumption in major abdominal surgery: a prospective, randomized, double-blind, controlled study 18499623 2008 05 23 2008 06 05 2013 11 21 1526-7598 106 6 2008 Jun Anesthesia and analgesia Anesth. Analg. Postoperative ketamine administration decreases morphine consumption in major abdominal surgery: a prospective, randomized, double-blind, controlled study. 1856-61 10.1213/ane.0b013e3181732776 Ketamine decreases postoperative morphine (...) consumption, but its optimal dosing and duration of administration remain unclear. In this study, we compared the effects of ketamine administration on morphine consumption limited to the intraoperative period, or continued for 48 h postoperatively. Eighty-one patients scheduled for abdominal surgery were prospectively randomized under double-blind conditions to three groups: (1) PERI group receiving intraoperative and postoperative ketamine for the first 48 h after surgery (2 microg x kg(-1) x min(-1

EvidenceUpdates2008

76. Adverse events associated with ketamine for procedural sedation in adults

Adverse events associated with ketamine for procedural sedation in adults Adverse events associated with ketamine for procedural sedation in adults Adverse events associated with ketamine for procedural sedation in adults Strayer RJ, Nelson LS CRD summary The review concluded that when ketamine was used for procedural sedation in adults, cardiorespiratory adverse events were rare but dysphoric emergence phenomena occurred in 10% to 20% patients and there was a likelihood of airway obstruction (...) . The reliability of the authors’ conclusions is uncertain due to review process limitations and uncertain quality and design of the many included studies. Authors' objectives To evaluate the safety of the use of ketamine for procedural sedation in adults. Searching PubMed, EMBASE, TOXNET (to May 2006) and The Cochrane Library were searched for publications in English, Spanish, Russian, French, Portuguese and German; search terms were reported. Australian Adverse Drug Reactions Bulletin, European Public

DARE.2008

77. Midazolam or ketamine for procedural sedation of children in the emergency department

Midazolam or ketamine for procedural sedation of children in the emergency department BestBets: Midazolam or ketamine for procedural sedation of children in the emergency department Midazolam or ketamine for procedural sedation of children in the emergency department Report By: Andrew Munro - Specialist in Emergency Medicine FACEM Search checked by Ian Machonochie - Consultant in Paediatric Emergency Medicine Institution: Coffs Harbour Base Hospital, NSW, Australia Date Submitted: 28th May 2003 (...) Date Completed: 27th July 2007 Last Modified: 18th June 2007 Status: Green (complete) Three Part Question In [children needing painful procedures in the emergency department] is [ midazolam or ketamine] [ safer and more effective at achieving conscious sedation]? Clinical Scenario A mother brings her five year old son to the Emergency Department (ED) with a deep scalp laceration having fallen onto the corner of a coffee table. The wound requires sutures. For various reasons the option

BestBETS2007

78. Low-dose ketamine in addition to propofol for procedural sedation and analgesia in the emergency department

Low-dose ketamine in addition to propofol for procedural sedation and analgesia in the emergency department Low-dose ketamine in addition to propofol for procedural sedation and analgesia in the emergency department Low-dose ketamine in addition to propofol for procedural sedation and analgesia in the emergency department Loh G, Dalen D CRD summary This review concluded that there is insufficient evidence to recommend the routine use of low-dose ketamine combined with propofol for procedural (...) sedation in the emergency department setting. Although the review has a number of weaknesses, this conclusion is appropriate. Authors' objectives To evaluate the safety and efficacy of low-dose intravenous ketamine with intravenous propofol for sedation and analgesia during emergency department procedures. Searching MEDLINE, EMBASE, BioMed Central, the Cochrane Library, International Pharmaceutical Abstracts and Google Scholar were searched from inception to February 2007; key search terms were

DARE.2007

79. Ketamine and postoperative pain: a quantitative systematic review of randomised trials

Ketamine and postoperative pain: a quantitative systematic review of randomised trials Ketamine and postoperative pain: a quantitative systematic review of randomised trials Ketamine and postoperative pain: a quantitative systematic review of randomised trials Elia N, Tramer M R CRD summary This review assessed the efficacy and safety of ketamine for the control of post-operative pain. The authors concluded that the role of ketamine in peri-operative analgesia remains unclear. The authors (...) acknowledged that the evidence was weak in some areas. However, their conclusions appear suitably cautious and the recommendations for further research seem reasonable. Authors' objectives To assess the benefits and harms of ketamine for the control of post-operative pain. Searching MEDLINE, EMBASE, CINAHL, Biosis Previews, IndMED and the Cochrane Controlled Trials Register were searched to November 2003 using the reported search terms. The bibliographies of retrieved reports and reviews were screened

DARE.2005

80. Guideline for ketamine sedation in emergency departments

Guideline for ketamine sedation in emergency departments Registered Charity No 273876 BRITISH ASSOCIATION FOR EMERGENCY MEDICINE Churchill House 3 rd Floor, 35 Red Lion Square London, WC1R 4SG United Kingdom Tel: +44 (0)20 7404 1999 Fax: +44 (0)20 7067 1267 Email: baem@emergencymedicine.uk.net Web: www.emergencymed.org.uk CLINICAL EFFECTIVENESS COMMITTEE GUIDELINE FOR KETAMINE SEDATION IN EMERGENCY DEPARTMENTS Introduction Ketamine is a powerful anaesthetic agent with anxiolytic and analgesic (...) and amnesic properties with a wide safety margin. This guideline covers its use in analgesic sedation, primarily for children. The doses advised for analgesic sedation are designed to leave the patient capable of protecting their airway. Consequently there is a significant risk of failure of sedation and the clinician must recognise that the option of general anaesthesia must be discussed with the patient and parents. Ketamine should be only used by clinicians experienced in its use and capable

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