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By Maureen Cameron I'm a paramedic
Henry David, Joseph Shipp
STUDY OBJECTIVE: We compare the frequency of respiratory depression during emergency department procedural sedation with ketamine plus propofol versus propofol alone. Secondary outcomes are provider satisfaction, sedation quality, and total propofol dose. METHODS: In this randomized, double-blind, placebo-controlled trial, healthy children and adults undergoing procedural sedation were pretreated with intravenous fentanyl and then randomized to receive either intravenous ketamine 0...
May 2011: Annals of Emergency Medicine
Jan Persson
For ketamine's fiftieth birthday, a narrative review of this unique drug in pain management is presented. Its history is traced from its conception, and its heritage, as a phencyclidine offspring, delineated. The earliest roots of the conceptions concerning the mechanisms of action are sought, and then followed in preclinical as well as clinical research. The major proposed mechanisms in the literature are commented on and evaluated. The growth of the clinical evidence for perioperative pain, acute pain, and chronic pain is followed from early attempts to systematic reviews...
June 2013: CNS Neuroscience & Therapeutics
Nicolas Gaspard, Brandon Foreman, Lilith M Judd, James N Brenton, Barnett R Nathan, Blathnaid M McCoy, Ali Al-Otaibi, Ronan Kilbride, Ivan Sánchez Fernández, Lucy Mendoza, Sophie Samuel, Asma Zakaria, Giridhar P Kalamangalam, Benjamin Legros, Jerzy P Szaflarski, Tobias Loddenkemper, Cecil D Hahn, Howard P Goodkin, Jan Claassen, Lawrence J Hirsch, Suzette M Laroche
PURPOSE: To examine patterns of use, efficacy, and safety of intravenous ketamine for the treatment of refractory status epilepticus (RSE). METHODS: Multicenter retrospective review of medical records and electroencephalography (EEG) reports in 10 academic medical centers in North America and Europe, including 58 subjects, representing 60 episodes of RSE that were identified between 1999 and 2012. Seven episodes occurred after anoxic brain injury. KEY FINDINGS: Permanent control of RSE was achieved in 57% (34 of 60) of episodes...
August 2013: Epilepsia
Steven M Green, Mark G Roback, Baruch Krauss
OBJECTIVE: The objective of this study was to assess predictors of emergency department (ED) ketamine-associated laryngospasm using case-control techniques. METHODS: We performed a matched case-control analysis of a sample of 8282 ED ketamine sedations (including 22 occurrences of laryngospasm) assembled from 32 prior published series. We sequentially studied the association of each of 7 clinical variables with laryngospasm by assigning 4 controls to each case while matching for the remaining 6 variables...
November 2010: Pediatric Emergency Care
Steven M Green, Mark G Roback, Baruch Krauss, Lance Brown, Ray G McGlone, Dewesh Agrawal, Michele McKee, Markus Weiss, Raymond D Pitetti, Mark A Hostetler, Joe E Wathen, Greg Treston, Barbara M Garcia Pena, Andreas C Gerber, Joseph D Losek
STUDY OBJECTIVE: Although ketamine is one of the most commonly used sedatives to facilitate painful procedures for children in the emergency department (ED), existing studies have not been large enough to identify clinical factors that are predictive of uncommon airway and respiratory adverse events. METHODS: We pooled individual-patient data from 32 ED studies and performed multiple logistic regressions to determine which clinical variables would predict airway and respiratory adverse events...
August 2009: Annals of Emergency Medicine
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