Anosmia – a potential complication of intranasal ketamine

Mayell, Antonia; Natusch, D.

doi:10.1111/j.1365-2044.2009.05911.x

Cited by 13 publications

(10 citation statements)

References 4 publications

(6 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Extensive use of IN ketamine (four sprays per hour over a period of months) resulted in anosmia in a woman suffering from breakthrough oncological pain [26]. In our study, IN ketamine showed nearly identical rates of adverse effects to that of IV and IM morphine, none of which were dangerous.…”

Section: Discussionsupporting

confidence: 48%

Intranasal ketamine for acute traumatic pain in the Emergency Department: a prospective, randomized clinical trial of efficacy and safety

et al. 2016

View full text Add to dashboard Cite

BackgroundKetamine has been well studied for its efficacy as an analgesic agent. However, intranasal (IN) administration of ketamine has only recently been studied in the emergency setting. The objective of this study was to elucidate the efficacy and adverse effects of a sub-dissociative dose of IN Ketamine compared to IV and IM morphine.MethodsA single-center, randomized, prospective, parallel clinical trial of efficacy and safety of IN ketamine compared to IV and IM morphine for analgesia in the emergency department (ED). A convenience sample of 90 patients aged 18–70 experiencing moderate-severe acute traumatic pain (≥80 mm on 100 mm Visual Analog Scale [VAS]) were randomized to receive either 1.0 mg/kg IN ketamine, 0.1 mg/kg IV MO or 0.15 mg/kg IM MO. Pain relief and adverse effects were recorded for 1 h post-administration. The primary outcome was efficacy of IN ketamine compared to IV and IM MO, measured by “time-to-onset” (defined as a ≥15 mm pain decrease on VAS), as well as time to and degree of maximal pain reduction.ResultsThe 3 study groups showed a highly significant, similar maximal pain reduction of 56 ± 26 mm for IN Ketamine, and 59 ± 22 and 48 ± 30 for IV MO and IM MO, respectively. IN Ketamine provided clinically-comparable results to those of IV MO with regards to time to onset (14.3 ± 11.2 v. 8.9 ± 5.6 min, respectively) as well as in time to maximal pain reduction (40.4 ± 16.3) versus (33.4 ± 18), respectively.ConclusionsIN ketamine shows efficacy and safety comparable to IV and IM MO. Given the benefits of this mode of analgesia in emergencies, it should be further studied for potential clinical applications.Trial registrationRetrospectively registered on 27 June 2016. ClinicalTrials.gov ID: NCT02817477 Electronic supplementary materialThe online version of this article (doi:10.1186/s12873-016-0107-0) contains supplementary material, which is available to authorized users.

show abstract

Section: Discussionsupporting

confidence: 48%

Intranasal ketamine for acute traumatic pain in the Emergency Department: a prospective, randomized clinical trial of efficacy and safety

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Intranasal administration of medications, specifically ketamine, has resulted in both transient and permanent complications. Carr et al reported the occurrence of transient nasal irritation after intranasal ketamine use, ( 10 ) while Mayell et al described a patient who developed permanent anosmia after the initiation of intranasal ketamine for analgesia in a chronic pain patient ( 11 ). Patients have also developed anosmia after the topical use of local anesthetics.…”

Section: Resultsmentioning

confidence: 99%

Postoperative Alterations in Taste and Smell

et al. 2014

View full text Add to dashboard Cite

Context:Alterations in taste and smell, including but not limited to anosmia, ageusia, hypogeusia, and dysgeusia, have been described in association with various medications, including anesthetic agents. Frequently, these symptoms occur 1-2 weeks after medication administration and last several months. While such a phenomenon is a rare occurrence, it nonetheless can significantly impact patients’ satisfaction and quality of life.Evidence Acquisition:The methodology consisted of a thorough literature search using the MEDLINE and Cochrane databases utilizing keywords such as anosmia, ageusia, olfactory disorders, postoperative, and anesthesia.Results:Our results yielded several previously published case report, and were not limited to a specific type of anesthesia. Based on available literature, we review the physiology of taste and smell as well as the medications associated with loss of these senses. We describe perioperative agents that could lead to postoperative complications associated with anosmia and and ageusia.Conclusions:Based on available literature recommendations for anesthesiologists caring for patients at risk for this occurrence are presented in this review. The symptoms are usually temporary as in the majority of the patients the sensory receptor cells are able to regenerate themselves after injury. Anesthesia providers need to aware of this phenomenon to be able to reassure patients and possibly avoid anesthetic techniques associated with anosmia and ageusia.

show abstract

“…To my mind, it is clear that ketamine should not be administered spinally, especially in view of the fact that the gains are not impressive [37]. In the vein of neurological toxicity, permanent anosmia has also been reported in a patient on long-term (6 months) therapy with intranasal ketamine for chronic pain [38], a route that has been questioned previously [39].…”

Section: Toxicitymentioning

confidence: 99%