Latest & greatest articles for ketamine

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Top results for ketamine

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

Postoperative analgesia and early rehabilitation after total knee replacement: a comparison of continuous low-dose intravenous ketamine versus nefopam 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-controlled intravenous morphine consumption, were assessed during 48h. We measured the maximal knee flexion on the third postoperative day, and the delay to obtain a 90 degrees flexion. Ketamine and nefopam reduced morphine consumption (p<0.0001). Pain scores, were lower at rest and on mobilization

2009 EvidenceUpdates Controlled trial quality: uncertain

82. Morphine with adjuvant ketamine vs. Higher doses of morphine alone for immediate post-thoracotomy analgesia (Abstract)

Morphine with adjuvant ketamine vs. Higher doses of morphine alone for immediate post-thoracotomy analgesia 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 more effective analgesia with fewer side effects than a standard morphine dose for early pain control.We conducted a 6-month randomized, double-blind study in patients undergoing thoracotomy for minimally invasive (...) direct coronary artery bypass or for lung tumor resection. After extubation, when objectively awake (>or= 5/10 visual analogue scale [VAS]) and complaining of pain (>or= 5/10 VAS), patients were connected to patient-controlled IV analgesia delivering 1.5 mg of morphine plus saline 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

2009 EvidenceUpdates Controlled trial quality: predicted high

83. Ketamine and lornoxicam for preventing a fentanyl-induced increase in postoperative morphine requirement (Abstract)

Ketamine and lornoxicam for preventing a fentanyl-induced increase in postoperative morphine requirement 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 of 1 microg x kg(-1), F), ketamine (infusion of 15 microg x kg(-1) x min(-1), K), ketamine and fentanyl (infusion of 15 microg x kg(-1) x min(-1) ketamine plus three bolus of 1 microg x kg(-1) fentanyl, FK), lornoxicam (one bolus of 8 mg, L

2009 EvidenceUpdates Controlled trial quality: predicted high

84. 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

2009 UTHSCSA Dental School CAT Library

85. 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 Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.

2009 DARE.

86. Etomidate versus ketamine for rapid sequence intubation in acutely ill patients: a multicentre randomised controlled trial. (Abstract)

Etomidate versus ketamine for rapid sequence intubation in acutely ill patients: a multicentre randomised controlled trial. 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 and 65 intensive care units in France. Patients were randomly assigned by a computerised random-number generator list to receive 0.3 mg/kg of etomidate (n=328) or 2 mg/kg of ketamine (n=327) for intubation. Only the emergency physician enrolling patients was aware of group

2009 Lancet Controlled trial quality: predicted high

87. Subdissociative-dose ketamine versus fentanyl for analgesia during propofol procedural sedation: a randomized clinical trial Full Text available with Trip Pro

Subdissociative-dose ketamine versus fentanyl for analgesia during propofol procedural sedation: a randomized clinical trial 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. Supplemental oxygen was not routinely administered. The primary outcomes were the frequency and severity of cardiorespiratory events and interventions, rated using a composite intrasedation event rating scale. Secondary outcomes included the frequency of specific scale component events, propofol doses required to achieve and maintain sedation

2008 EvidenceUpdates Controlled trial quality: predicted high

88. 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

2008 BestBETS

89. 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

2008 BestBETS

90. Effects of intra-articular ketamine on pain and somatosensory function in temporomandibular joint arthralgia patients (Abstract)

Effects of intra-articular ketamine on pain and somatosensory function in temporomandibular joint arthralgia patients 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 of somatosensory function at baseline and up to 15 min after injections. There were no significant effects of intra-articular ketamine over time on spontaneous VAS pain measures (ANOVA: P=0.532), pain on jaw

2008 EvidenceUpdates Controlled trial quality: uncertain

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

Postoperative ketamine administration decreases morphine consumption in major abdominal surgery: a prospective, randomized, double-blind, controlled study 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) after a 0.5 mg/kg bolus); (2) INTRA group receiving intraoperative ketamine administration only (2 microg x kg(-1) x min(-1) after a 0.5 mg/kg bolus); and (3) CTRL group receiving placebo. Morphine consumption, visual analog scale scores and side effects (sedation score, nausea-vomiting score

2008 EvidenceUpdates Controlled trial quality: predicted high

92. 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

2008 DARE.

93. 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

2007 BestBETS

94. Low-dose ketamine in addition to propofol for procedural sedation and analgesia in the emergency department Full Text available with Trip Pro

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

2007 DARE.

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

Ketamine and postoperative pain: a quantitative systematic review of randomised trials Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.

2005 DARE.

96. Ketamine as an adjuvant to opioids for cancer pain. Full Text available with Trip Pro

Ketamine as an adjuvant to opioids for cancer pain. Ketamine is a commonly used anaesthetic agent, and in subanaesthetic doses is also given as an adjuvant to opioids for the treatment of cancer pain, particularly when opioids alone prove to be ineffective. Ketamine is known to have hallucinogenic side effects. To date no systematic review of the benefits and harms of adjuvant ketamine for cancer pain has been undertaken.To determine the effectiveness and adverse effects of ketamine (...) as an adjuvant to opioids in the treatment of cancer pain.Studies were identified from MEDLINE (1966-2001), EMBASE (1980-2001), CancerLit (1966-2001), the Cochrane Library (Issue 1, 2001); by handsearching reference lists from review articles, trials, and chapters from standard textbooks on pain and palliative care. The manufacturer of ketamine (Pfizer Parke-Davis) provided search results from their in-house database, PARDLARS.RCTs of adult patients with cancer and pain being treated with an opioid

2003 Cochrane

97. Ketamine in chronic pain management: an evidence-based review

Ketamine in chronic pain management: an evidence-based review Ketamine in chronic pain management: an evidence-based review Ketamine in chronic pain management: an evidence-based review Hocking G, Cousins M J CRD summary This review assessed the effectiveness of ketamine for chronic pain. The authors concluded that there is moderate to weak evidence about ketamine and that further controlled trials are required. The lack of a validity assessment and the inadequate reporting of the methods used (...) to conduct the review hamper an assessment of the evidence. The studies were generally of a poor quality, so the evidence is weak. Authors' objectives To evaluate the potential effectiveness of ketamine for treating chronic pain. Searching MEDLINE and EMBASE were searched from 1966 to August 2002 without any language restrictions; the search terms were reported. In addition, the Reference lists of retrieved articles and reviews were checked. Abstracts and unpublished studies were excluded. Authors

2003 DARE.

98. Does ketamine have a role in managing severe exacerbation of asthma in adults?

Does ketamine have a role in managing severe exacerbation of asthma in adults? Does ketamine have a role in managing severe exacerbation of asthma in adults? Does ketamine have a role in managing severe exacerbation of asthma in adults? Lau T T, Zed P J Authors' objectives To evaluate the role of ketamine in the management of severe exacerbation of asthma in adults. Searching MEDLINE (from January 1966 to September 2000), EMBASE (from January 1988 to September 2000) and the Cochrane Database (...) of Systematic Reviews (Issue 2, 2000) were searched for publications in the English language, using the search terms 'ketamine', 'status asthmaticus' and 'asthma'. The references in relevant literature were also examined. Study selection Study designs of evaluations included in the review All articles of any study design were eligible for inclusion in the review. Specific interventions included in the review Ketamine therapy comprised 0.75 mg/kg intravenous (i.v.) bolus, then 0.75 mg/kg i.v. over 10 minutes

2001 DARE.

99. Does midazolam alter the clinical effects of intravenous ketamine sedation in children? A double-blind, randomized, controlled, emergency department trial

Does midazolam alter the clinical effects of intravenous ketamine sedation in children? A double-blind, randomized, controlled, emergency department trial PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

2000 PedsCCM Evidence-Based Journal Club