Oral ketamine and dexmedetomidine in adults’ burns wound dressing—A randomized double blind cross over study

Kundra, Pankaj; Velayudhan, Savitri; Srinivasan, Krishnamachari; Gupta, Suman Lata

doi:10.1016/j.burns.2013.02.012

Cited by 36 publications

(27 citation statements)

References 13 publications

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“…In a double-blind study of spine surgery patients, both low-dose ketamine and dexmedetomidine infusions provided good analgesia and decreased rescue opioid use compared with saline (Garg et al, 2016). However, oral dexmedetomidine is not as strong an analgesic as oral ketamine according to a double-blind study of patients undergoing burn wound dressing changes (Kundra, Velayudhan, Krishnamachari, & Gupta, 2013). Clonidine, which is available for multiple routes of administration including oral, has long been used to treat hypertension and may be an opioid-sparing addition to multimodal analgesia (Oyler et al, 2015).…”

Section: Resultsmentioning

confidence: 99%

“…The drug may decrease pain hypersensitivity and windup pain (i.e., the continuation of pain sensation despite the absence of a stimulus) (Kundra et al, 2013) as well as opioid tolerance (Subramaniam, Subramaniam, & Steinbrook, 2004) and so might be particularly appropriate for patients with long-term opioid use (Goltser, Soleyman-Zomalan, Kresch, & Motov, 2015). …”

Section: Resultsmentioning

confidence: 99%

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Exploring Opioid-Sparing Multimodal Analgesia Options in Trauma: A Nursing Perspective

Sullivan

Lyons

Montgomery

et al. 2016

Journal of Trauma Nursing

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Exploring Opioid-Sparing Multimodal Analgesia Options in Trauma: A Nursing Perspective

Sullivan

Lyons

Montgomery

et al. 2016

Journal of Trauma Nursing

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“…None of the patients sedated with dexmedetomidine had any postoperative complications after the procedure. This result is also similar to other studies such as Surendar et al .,[ 1 ] Kundra et al .,[ 28 ] and Akin et al .,[ 25 ] whereas Gyanesh et al . [ 29 ] reported vomiting in two patients treated with intranasal dexmedetomidine.…”

Section: Discussionmentioning

confidence: 99%

Comparative evaluation of dexmedetomidine and midazolam-ketamine combination as sedative agents in pediatric dentistry: A double-blinded randomized controlled trial

et al. 2016

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Background:Pharmacological methods have been used as an adjunct to enhance child cooperativeness and facilitate dental treatment.Objective:Purpose of this study was to evaluate and compare the effect of sedation by intranasal dexmedetomidine and oral combination drug midazolam–ketamine in a group of children with uncooperative behavior requiring dental treatment.Materials and Methods:This was a prospective, randomized, double-blind study that included patients 3–9 years old with American Society of Anesthesiologists-I status. About 36 children presenting early childhood caries were randomly assigned to one of three groups studied: Group MK received intranasal saline and oral midazolam (0.5 mg/kg) with ketamine (5 mg/kg) mixed in mango juice; Group DX received intranasal dexmedetomidine (1 μg/kg) and oral mango juice; and Group C received intranasal saline and oral mango juice. Patients' heart rate, blood pressure, and oxygen saturation were recorded before, during, and at the end of the procedure. Patients' behavior, sedation status, and wake up behavior were evaluated with modified observer assessment of alertness and sedation scale. Ease of treatment completion was evaluated according to Houpt scale.Results:Hemodynamic changes were statistically insignificant in Group MK and Group DX. About 75% patients in Group MK were successfully sedated as compared to 53.9% Group DX and none of the patients in Group C. Ease of treatment completion was better with Group MK as compared to Group DX and least with Group C. Around 50% patients in Group MK had postoperative complications.Conclusion:Oral midazolam–ketamine combination and intranasal dexmedetomidine evaluated in the present study can be used safely and effectively in uncooperative pediatric dental patients for producing conscious sedation.

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“…Historically, ketamine has played a prominent role in burn care protocols, providing effective analgesia and sedation for burn patients who must undergo debridements, grafts, and repeated dressing changes (Demling et al, 1978; Hondorp, 1987; Canpolat et al, 2012; Kundra et al, 2013) without compromising the airway or respiratory function. Furthermore, the ability to administer ketamine intramuscularly and even orally provides an additional advantage in burn patients who have extensive scarring that might make IV administration challenging.…”

Section: Clinical Uses In Medicinementioning

confidence: 99%

Ketamine: 50 Years of Modulating the Mind

Vlisides

2016

Front. Hum. Neurosci.

272

212

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Ketamine was introduced into clinical practice in the 1960s and continues to be both clinically useful and scientifically fascinating. With considerably diverse molecular targets and neurophysiological properties, ketamine’s effects on the central nervous system remain incompletely understood. Investigators have leveraged the unique characteristics of ketamine to explore the invariant, fundamental mechanisms of anesthetic action. Emerging evidence indicates that ketamine-mediated anesthesia may occur via disruption of corticocortical information transfer in a frontal-to-parietal (“top down”) distribution. This proposed mechanism of general anesthesia has since been demonstrated with anesthetics in other pharmacological classes as well. Ketamine remains invaluable to the fields of anesthesiology and critical care medicine, in large part due to its ability to maintain cardiorespiratory stability while providing effective sedation and analgesia. Furthermore, there may be an emerging role for ketamine in treatment of refractory depression and Post-Traumatic Stress Disorder. In this article, we review the history of ketamine, its pharmacology, putative mechanisms of action and current clinical applications.

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Oral ketamine and dexmedetomidine in adults’ burns wound dressing—A randomized double blind cross over study

Cited by 36 publications

References 13 publications

Exploring Opioid-Sparing Multimodal Analgesia Options in Trauma: A Nursing Perspective

Exploring Opioid-Sparing Multimodal Analgesia Options in Trauma: A Nursing Perspective

Comparative evaluation of dexmedetomidine and midazolam-ketamine combination as sedative agents in pediatric dentistry: A double-blinded randomized controlled trial

Ketamine: 50 Years of Modulating the Mind

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