In vivo spasmolytic effect of ketamine and adrenaline on histamine‐induced airway constriction

Hirota, Kazuyoshi; Hashimoto, Yuichi; Sakai, Tamami; Sato, Tetsumi; Ishihara, Hironori; Matsuki, Akitomo

doi:10.1111/j.1399-6576.1998.tb05106.x

Cited by 13 publications

(6 citation statements)

References 23 publications

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“…We anesthetized the patient with propofol, fentanyl and ketamine. Propofol (7) and ketamine (8) have been reported to produce bronchodilation. Although the use of fentanyl for asthmatic patients is controversial, Zappi and colleagues (9) reported that opioids relax airway smooth muscles via μ‐opioid receptors.…”

Section: Discussionmentioning

confidence: 99%

Use of olprinone, a phosphodiesterase III inhibitor, in an asthmatic patient

Hirota

Kabara

Hashimoto

et al. 2001

Acta Anaesthesiol Scand

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Phosphodiesterase (PDE) III exists in airway smooth muscles. In addition, PDEIII inhibitors have been suggested to relax airway smooth muscle by increasing intracellular cAMP concentrations. We report a successful use of olprinone, a PDEIII inhibitor, for treatment of an asthmatic attack. A 15-year-old male patient treated with oral theophylline 400 mg x d(-1) was anesthetized with propofol, fentanyl and ketamine for knee joint surgery. Immediately after tracheal intubation, an asthma attack occurred with peak airway pressure (Paw)>40 cmH2O. Thus, propofol 20 mg was additionally given to increase anesthetic depth, and Paw gradually decreased to 30 cmH2O. In addition, we started monitoring bronchial cross-sectional area using a superfine fiberoptic bronchoscopic method previously reported. However, as Paw did not further decrease for 30 min, olprinone was intravenously infused (10 microg x kg(-1) x 10 min(-1) + 0.3 microg x kg(-1) x min(-1), total 5 mg). Olprinone infusion rapidly decreased peak Paw from 30 cmH2O to 24 cmH2O and increased bronchial cross-sectional area by 50%. These findings suggest that olprinone produced bronchodilation.

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Section: Discussionmentioning

confidence: 99%

Use of olprinone, a phosphodiesterase III inhibitor, in an asthmatic patient

Hirota

Kabara

Hashimoto

et al. 2001

Acta Anaesthesiol Scand

Self Cite

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“…Ketamine, adrenaline, isoflurane, theophylline and salbutamol have been used in the management of bronchospasm as they all have bronchodilatatory properties in both human beings and dogs [8][9][10][11][12][13][14][15][16][17] . None of these treatments showed clear and complete resolution of the clinical signs and it is not possible to clearly associate the success of the treatment to one specific drug; most likely their combination led to the resolution of clinical symptoms.…”

Section: Treatmentmentioning

confidence: 99%

Bronchial blocker‐induced bronchospasm in a dog

Mirra

Iff

2018

Vet Record Case Reports

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A 12-year-old female labrador retriever weighing 27 kg required anaesthesia for an explorative thoracoscopy and intrathoracic mass biopsy. One lung ventilation was achieved using a bronchial blocker. After surgery, the dog was moved to the induction room with the bronchial blocker still in place. Once reconnected to an anaesthetic machine, absent capnography trace during mechanical ventilation, increased circuit pressure during manual ventilation and reduced tidal volume with subsequent haemoglobin desaturation occurred. After excluding other possible causes, bronchospasm due to direct bronchial blocker stimulation was suspected. Removal of the bronchial blocker, reintubation with a new endotracheal tube, administration of ketamine, adrenaline, isoflurane, theophylline and salbutamol led to the resolution of the clinical symptoms within four hours. No further episodes occurred. The dog was discharged in good general conditions seven days later.

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“…52 Specifically in pediatric patients, ketamine can provide sedation safely in those with asthma who require noninvasive mechanical ventilation with minimal respiratory depression and promotion of bronchodilation. 53 In these same patients who require intubation, ketamine has been shown to be safe and efficacious as an induction agent for intubation of critically ill patients. 54,55 Subhypnotic doses of ketamine administered by continuous infusion have been used for patients in the ICU to decrease total required opioid and other sedative doses.…”

Section: Ketaminementioning

confidence: 99%

Pediatric Critical Care Perceptions on Analgesia, Sedation, and Delirium

Smith

Berutti

Brink

et al. 2013

Semin Respir Crit Care Med

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Critically ill children suffer from pain and anxiety additionally in the face of severe organ dysfunction. The critical care environment challenges pediatric patients' emotional and developmental capabilities. Disease-focused therapy is a priority and usually requires separation of patient from family and completion of invasive procedures. With the lack of familiar surroundings, inability to self-soothe, and deficiency of sleep, critically ill children may benefit from a multidisciplinary approach to care with a specific goal of pain management. Due to the challenges unique to critical care of children, sedatives and hypnotics are heavily relied upon to "protect" children from the intensive care experience. Delirium occurs in at least 30% of critically ill infants and children reported in small prospective studies, without a large-scale protocol for delirium monitoring. Adult studies demonstrate an overwhelming prevalence of delirium in the critically ill, associated with significant morbidity and mortality. Recently, the diagnosis of pediatric delirium has been enhanced by the validation of bedside tools that encourage monitoring within the critical care setting. Though there are likely many similarities in delirium among adults and children, there is much to learn in regard to unique risk factors and outcomes for children. Perhaps, considering the neurodevelopmental and psychosocial capacities of a child, a creative approach to assess and control pain and anxiety, while optimizing disease-related therapies, may ultimately minimize the risk for the development of delirium or other long-term complications of critical illness.

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In vivo spasmolytic effect of ketamine and adrenaline on histamine‐induced airway constriction

Abstract: We have found that K could reverse the H-induced bronchoconstriction and potentiate the A-induced bronchial relaxation.

Cited by 13 publications

References 23 publications

Use of olprinone, a phosphodiesterase III inhibitor, in an asthmatic patient

Use of olprinone, a phosphodiesterase III inhibitor, in an asthmatic patient

Bronchial blocker‐induced bronchospasm in a dog

Pediatric Critical Care Perceptions on Analgesia, Sedation, and Delirium

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