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Intravenous ketamine

Vanita Ahuja, Deepak Thapa, Babita Ghai
Postamputation limb pain or phantom limb pain (PLP) develops due to the complex interplay of peripheral and central sensitization. The pain mechanisms are different during the initial phase following amputation as compared with the chronic PLP. The literature describes extensively about the management of established PLP, which may not be applicable as a preventive strategy for PLP. The novelty of the current narrative review is that it focuses on the preventive strategies of PLP. The institution of preoperative epidural catheter prior to amputation and its continuation in the immediate postoperative period reduced perioperative opioid consumption (Level II)...
October 2018: Journal of Anaesthesiology, Clinical Pharmacology
Ming-Shan Chen, Wen-Chun Lin, Hsuan-Te Yeh, Chia-Lin Hu, Shew-Meei Sheu
Neutrophil extracellular traps (NETs) are net-like chromatin fibers that can trap and kill microorganisms. Although several anti-inflammatory effects of intravenous anesthetics have been reported, it has not been investigated whether intravenous anesthetics influence NET formation. AIMS: To compare the effects of four intravenous anesthetics (propofol, thiamylal sodium, midazolam, and ketamine) on phorbol myristate acetate (PMA)-induced NET formation and analyze the associated signaling pathways...
February 13, 2019: Life Sciences
Kelly A Bryant, Murat Altinay, Nora Finnegan, Kim Cromer, Roman M Dale
PURPOSE: There is an immediate need for more sustainable, effective therapies for treatment-resistant depression in patients who do not respond to traditional psychopharmacology. The aim of this study was to determine the efficacy and safety of intravenous ketamine infusions on the elderly population by using a case series of 6 geriatric patients with treatment-resistant depression. METHODS: Eligible patients aged 65 to 82 were given a subanesthetic ketamine hydrochloride dose of 0...
February 7, 2019: Journal of Clinical Psychopharmacology
Lorenzo Moccia, Anna Tofani, Marianna Mazza, Marcello Covino, Giovanni Martinotti, Fabrizio Schifano, Luigi Janiri, Marco Di Nicola
Novel psychoactive substances (NPSs) have currently become a major public health concern because of relatively easy accessibility to these compounds and difficulty in identifying them with routine laboratory techniques. Here, we report the 18 F-fluorodeoxyglucose positron emission tomography/computerized tomography (18 F-FDG PET/CT) case study of a 23-year-old man who developed a substance-induced psychotic disorder after having intravenously injected himself with an unspecified amount of methoxetamine (MXE), a ketamine derivative hallucinogen...
February 9, 2019: Journal of Psychoactive Drugs
Michael Zhang, Kennett D Radford, Mercedes Driscoll, Salsabila Purnomo, Jean Kim, Kwang H Choi
Ketamine, a multimodal dissociative anesthetic, is a powerful analgesic administered following trauma due to its hemodynamic and respiratory stability. However, ketamine can cause hallucination and dissociation which may adversely impact traumatic memory after an injury. The effects of ketamine on proteins implicated in neural plasticity are unclear due to different doses, routes, and timing of drug administration in previous studies. Here, we investigated the effects of a single intravenous (IV) ketamine infusion on protein levels in three brain regions of rats...
June 2019: IBRO Reports
Gillian M Chumbley, Lindsey Thompson, Joanna E Swatman, Catherine Urch
INTRODUCTION: Pain which persists after thoracotomy is well recognized, and activation of the N-methyl-d-aspartate (NMDA) receptor could be a contributing factor. This study sought to establish whether ketamine given peri-operatively could reduce persistent post-surgical pain. TRIAL DESIGN: Double-blind, randomized, placebo-controlled trial comparing low-dose intravenous ketamine and saline placebo. METHODS: Seventy patients undergoing thoracotomy were randomized to receive either intravenous ketamine (0...
February 4, 2019: European Journal of Pain: EJP
Kanta Kido, Shinichi Toda, Yuki Shindo, Hitoshi Miyashita, Shigekazu Sugino, Eiji Masaki
Purpose: Remifentanil is associated with acute opioid tolerance that can lead to increased postoperative consumption of opioid analgesics. The purpose of this study was to determine whether a low dose of ketamine prevents remifentanil-induced acute opioid tolerance and affects the neutrophil-lymphocyte ratio (NLR), a newly recognized biomarker of inflammation. Materials and methods: Forty patients undergoing orthognathic surgery were enrolled in this prospective, randomized, double-blind study and randomly assigned to intraoperative administration of one of the following anesthetic regimens: high-dose remifentanil (0...
2019: Journal of Pain Research
H Z Ozsoy
Inhalational anesthetics such as isoflurane, desflurane and halothane are the mainstay medications for surgical procedures; upon inhalation, they produce anesthesia described as reversible unconsciousness with the features of amnesia, sleep, immobility and analgesia. To date, how they produce anesthesia is unknown. This study proposes that carbonic anhydrase enzymes are likely targets mediating the actions of inhalational anesthetics. Carbonic anhydrase enzymes, commonly expressed in living organisms, utilize carbon dioxide (CO2 ) as a substrate and can generate H+ and HCO3 - from CO2 with a great efficiency...
February 2019: Medical Hypotheses
A Lemoine, E Lambaudie, F Bonnet, E Leblanc, P Alfonsi
The following recommendations cover the perioperative management of ovarian, Fallopian tube and primary peritoneal cancers. Five questions related to pre-habilitation and enhanced recovery after surgery were evaluated. The conclusions and recommendations are based on an analysis of the level of evidence available in the literature. These recommendations are part of the overall recommendations for improving the management of ovarian, fallopian or primary peritoneal cancer, made with the support of INCa (Institut National du Cancer)...
January 24, 2019: Gynecologie, Obstetrique, Fertilite & Senologie
R Muralidhar, Lal Churawan, M Sekar, A P Chidambaram, P Mugdha, D Ramamurthy
Purpose: The aim of this article is to study the feasibility of a delayed adjustable technique of strabismus surgery in children using an optional adjustable suture technique. Methods: The retrospective study included patients <12 years of age. Recessions were done using an optional adjustable bow-tie technique and resections were done by the conventional technique. Patients were evaluated on the third postoperative day and adjustments done when needed. Statistical analysis was done using Microsoft Excel 2010®...
February 2019: Indian Journal of Ophthalmology
S M Liu, Y Yue
Objective: To compare the analgesic efficacy between preoperative single-dose ketamine, a short-acting medicine and parecoxib, a long-acting medicine for reducing analgesic consumption in the first 24 h after-operation. Methods: Eighty-one patients from Beijing Chaoyang Hospital undergoing laparoscopic uterus surgery between April and December 2015 were randomly divided into three groups: control group (group C), ketamine group (group K) and parecoxib sodium group (group P). All patients were anesthetized with general anesthesia and received sufentanil-based patient-controlled intravenous analgesia (PCIA)...
December 25, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Rebecca McMillan, Anna Forsyth, Doug Campbell, Gemma Malpas, Elizabeth Maxwell, Juergen Dukart, Joerg Hipp, Suresh Muthukumaraswamy
BACKGROUND: Pharmacological magnetic resonance imaging has been used to investigate the neural effects of subanaesthetic ketamine in healthy volunteers. However, the effect of ketamine has been modelled with a single time course and without consideration of physiological noise. AIMS: This study aimed to investigate ketamine-induced alterations in resting neural activity using conventional pharmacological magnetic resonance imaging analysis techniques with physiological noise correction, and a novel analysis utilising simultaneously recorded electroencephalography data...
January 21, 2019: Journal of Psychopharmacology
Marlene P Freeman, George I Papakostas, Bettina Hoeppner, Erica Mazzone, Heidi Judge, Cristina Cusin, Sanjay Mathew, Gerard Sanacora, Dan Iosifescu, Charles DeBattista, Madhukar H Trivedi, Maurizio Fava
BACKGROUND: While ketamine has been increasingly studied for treatment resistant depression (TRD), the impact of sex differences on treatment outcomes has not been well studied. The objective was to ascertain whether there were differences in response to a single administration of ketamine for TRD between men and women, and between pre- and post-menopausal women. METHODS: A randomized, double-blind, placebo-controlled trial (N = 99; N = 50 male; N = 49 female) was conducted to investigate the efficacy of intravenous ketamine versus active placebo as augmentation of antidepressant therapy for TRD...
January 8, 2019: Journal of Psychiatric Research
Christopher Chang, Patrick McDonnell, M Eric Gershwin
Complex regional pain syndrome (CRPS) has been considered to be an autoimmune disease and there have been clinical trials with intravenous immunoglobulin. Often the etiology of the so-called CRPS diagnosis cannot be discerned and there are no validated instruments that provide functional metrics. The term complex regional pain syndrome (CRPS), coined in 1994 to describe patients in whom the pain is out of proportion to the injury, was actually a diagnosis proposed during the American Civil War, but was originally known as causalgia...
January 11, 2019: Autoimmunity Reviews
David Dadiomov, Kelly Lee
Introduction: Suicidality and self-injurious behavior afflict patients with a wide variety of psychiatric illnesses. Currently, there are few pharmacologic treatments for suicidality and self-injurious behavior and none that treat these conditions emergently. Recently, ketamine has demonstrated efficacy in treating both depression and acute suicidal ideation. An increasing usage of ketamine, of a variety of formulations, has been studied for these indications. This article reviews the evidence for use of ketamine in self-injurious behavior and suicidality...
January 2019: The mental health clinician
Maurizio Fava, Marlene P Freeman, Martina Flynn, Heidi Judge, Bettina B Hoeppner, Cristina Cusin, Dawn F Ionescu, Sanjay J Mathew, Lee C Chang, Dan V Iosifescu, James Murrough, Charles Debattista, Alan F Schatzberg, Madhukar H Trivedi, Manish K Jha, Gerard Sanacora, Samuel T Wilkinson, George I Papakostas
Supplementary Figure 1 and Supplementary Tables 1-4 have been re-uploaded so as to reflect the versions supplied during proofs stage. The publisher apologizes for the error in versioning. The HTML version of the paper has been updated.
January 7, 2019: Molecular Psychiatry
Narjes Akhlaghi, Pooya Payandemehr, Mehdi Yaseri, Ali A Akhlaghi, Ali Abdolrazaghnejad
STUDY OBJECTIVE: We evaluate the effect of midazolam and haloperidol premedication for reducing ketamine-induced recovery agitation in adult patients undergoing procedural sedation. We also compare physician satisfaction and recovery time. METHODS: We randomized emergency department patients older than 18 years who needed procedural sedation to receive 1 of the following 3 interventions in double-blind fashion 5 minutes before receiving intravenous ketamine at 1 mg/kg: intravenous distilled water, intravenous midazolam at 0...
January 3, 2019: Annals of Emergency Medicine
Chiara E Hampton, Thomas W Riebold, Nicole L LeBlanc, Katherine F Scollan, Ronald E Mandsager, David D Sisson
OBJECTIVE To compare effects of tiletamine-zolazepam, alfaxalone, ketamine-diazepam, and propofol for anesthetic induction on cardiorespiratory and acid-base variables before and during isoflurane-maintained anesthesia in healthy dogs. ANIMALS 6 dogs. PROCEDURES Dogs were anesthetized with sevoflurane and instrumented. After dogs recovered from anesthesia, baseline values for cardiorespiratory variables and cardiac output were determined, and arterial and mixed-venous blood samples were obtained. Tiletamine-zolazepam (5 mg/kg), alfaxalone (4 mg/kg), propofol (6 mg/kg), or ketamine-diazepam (7 and 0...
January 2019: American Journal of Veterinary Research
Naji C Salloum, Maurizio Fava, Marlene P Freeman, Martina Flynn, Bettina Hoeppner, Rebecca S Hock, Cristina Cusin, Dan V Iosifescu, Madhukar H Trivedi, Gerard Sanacora, Sanjay J Mathew, Charles Debattista, Dawn F Ionescu, George I Papakostas
OBJECTIVE: To examine the effect of high baseline anxiety on response to ketamine versus midazolam (active placebo) in treatment-resistant depression (TRD). METHODS: In a multisite, double-blind, placebo-controlled trial, 99 subjects with TRD were randomized to one of five arms: a single dose of intravenous ketamine 0.1, 0.2, 0.5, 1.0 mg/kg, or midazolam 0.045 mg/kg. The primary outcome measure was change in the six-item Hamilton Rating Scale for Depression (HAMD6)...
December 30, 2018: Depression and Anxiety
Wei Zheng, Yan-Ling Zhou, Wei-Jian Liu, Cheng-Yu Wang, Yan-Ni Zhan, Han-Qiu Li, Li-Jian Chen, Ming-D Li, Yu-Ping Ning
OBJECTIVE: Ketamine has demonstrated a rapid antidepressant and antisuicidal effect in patients with major depressive disorder (MDD), but the neurocognitive effects of ketamine are relatively unknown. This study aims to examine the neurocognitive effects of six ketamine infusions and the association of baseline neurocognitive function and the change in severity of depressive symptoms after the last infusions. METHODS: Sixty-four patients with MDD completed six intravenous infusions of ketamine (0...
December 10, 2018: Journal of Affective Disorders
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