The effects of propofol-midazolam-ketamine co-induction on hemodynamic changes and catecholamine response

Abbasivash, Rahman; Aghdashi, Mir Moussa; Sinaei, Behzad; Kheradmand, Fatemeh

doi:10.1016/j.jclinane.2014.05.014

Cited by 13 publications

(12 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although SBE is relatively a noninvasive operation, the insertion of the mirror and tube may cause abdominal pain, distension, nausea, vomiting, and other discomfort while the patient is awake. In clinic, sedation is applied to provide the endoscopist a better operational environment [39][40][41]. Due to the advances in medical techniques, general anesthesia is safer than sedation and provides a more comfortable medical treatment.…”

Section: Gastroenterology Research and Practicementioning

confidence: 99%

Diagnostic Value and Safety of Emergency Single-Balloon Enteroscopy for Obscure Gastrointestinal Bleeding

Yi-pin

Jiang

Chen

et al. 2019

Gastroenterology Research and Practice

View full text Add to dashboard Cite

Background. This study assesses the diagnostic performance of emergency single-balloon enteroscopy (SBE) for obscure gastrointestinal bleeding (OGIB) under general anesthesia versus conscious sedation. Study. The data of 102 OGIB in-patients from June 2015 to June 2018 were retrospectively analyzed. The diagnosis and detection rates and adverse events were calculated overall and in relation to age, gender, type of operation and anesthesia, bleeding type, different times of examination, and SBE route. All statistical analyses were performed using SPSS 24.0, and the diagnosis and detection rates were compared using the Chi-square test. Results. Among the 102 patients, 66 patients had positive findings, while 11 patients had suspected positive findings, and the diagnosis and detection rates were 64.7% and 75.5%, respectively. Ulcers (19.6%) and tumors (16.7%) were the most common causes of OGIB. There were no statistical differences in diagnosis and detection rates between the ages of ≥60 and <60 and between different genders. Patients with emergency SBE had higher diagnosis and detection rates (68.6% vs. 35.3%, P=0.023; 80.0% vs. 47.1%, P=0.016, respectively), when compared with nonemergency SBE patients. The diagnosis rate at 24 hours was higher than that at 2-7 days and one week (88.0% vs. 61.5%, P=0.030; 88.0% vs. 53.8%, P=0.007). For overt bleeding, the difference in diagnosis rates at 24 hours, 2-7 days, and one week was statistically significant (100.0% vs. 57.1%, P=0.006; 100.0% vs. 57.1%, P=0.006). For occult bleeding, the pairwise comparison revealed no statistical difference. Patients with general anesthesia had a higher detection rate, when compared to patients with conscious sedation (87.9% vs. 63.9%, P=0.004). In addition, adverse events under general anesthesia were lower, when compared to adverse events under conscious sedation (28.8% vs. 69.4%, P=0.020). There was no significant difference in adverse events at the different time points (P>0.05). Conclusion. Emergency SBE under general anesthesia achieves higher diagnosis and detection rates, and fewer adverse events under conscious sedation, when compared to nonemergency SBE, regardless of the route. For patients with overt bleeding, it is easier to find lesions by emergency SBE within 24 hours.

show abstract

Section: Gastroenterology Research and Practicementioning

confidence: 99%

Diagnostic Value and Safety of Emergency Single-Balloon Enteroscopy for Obscure Gastrointestinal Bleeding

Yi-pin

Jiang

Chen

et al. 2019

Gastroenterology Research and Practice

View full text Add to dashboard Cite

show abstract

“…Although there is a regularly taught principle that ketamine will cause patients to become hypertensive and tachycardic, multiple studies have examined the use of ketamine for sedation and induction for RSI and found that ketamine, alone or in combination with other drugs, maintains hemodynamic neutrality without causing severe hypertensive or tachycardic responses (50,(57)(58)(59)(60)(61)(62)(63)(64).…”

Section: Resultsmentioning

confidence: 99%

Intubation of the Neurologically Injured Patient

Bucher

Koyfman

2015

The Journal of Emergency Medicine

View full text Add to dashboard Cite

“…Previous studies regarding ketamine use during intubation in an in-hospital setting have reported variable results with respect to its effect on BP and HR. For example, Ayatollah et al [14] and Rajan et al [15] reported decreased BP and HR [15], [19] while Ozcan et al [16] and Kim et al [17], reported an increase in both of these parameters after ketamine administration. Barois et al [18] reported decreased BP but an increase in HR.…”

Section: Effects Of Ketamine On Vital Signs In the In-hospital Settingmentioning

confidence: 99%

“…It may also indirectly explain why hypotension was less associated with ketamine dose, as physicians are more likely to give lower doses of ketamine to the more severely ill patients with multiple comorbidities, who are the same patients that are more likely to develop hypotension with ketamine. Nonetheless, ketamine remains a useful anesthetic for RSI and in many studies has proven to be as effective as the gold standard "etomidate" with some favoring ketamine in some circumstances [19] .…”

Section: Ketamine-induced Changes In Blood Pressure and Heart Rate Inmentioning

confidence: 99%

Ketamine-induced Changes in Blood Pressure and Heart Rate in Pre-hospital Intubated Patients

Sheth

Brand²,

Halterman

2017

Adv. J. Grad. Res.

View full text Add to dashboard Cite

A B S T R A C TWhen a patient experiences trauma, pre-hospital rapid sequence intubation (RSI) is often the course of action. While RSI is associated with favorable neurological outcomes among traumatic brain injury patients, it also carries the risk of increased hypotension and bradycardia. Ketamine is a fast-acting anesthetic agent used in RSI, attractive due to its ability to raise heart rate (HR) and blood pressure (BP) and thus potentially lessening the severity of RSIrelated hypotension and bradycardia. However, research in support of its use is inconclusive, with different studies reporting increases or decreases in BP and HR after ketamine administration. To study the effect of ketamine on HR and BP during RSI, we analyzed the data obtained from 1,516 patients who received trauma and nontrauma medical care including RSI from first responders and emergency personnel using two different statistical methods. We determined if there was any association between the vital signs prior to administration of ketamine and outcomes such as bradycardia and/or hypotension post-ketamine administration in patients undergoing RSI. We found that the vital signs prior to administration of ketamine (i.e. BP and HR) predict the development of bradycardia and/or hypotension in patients undergoing RSI and the relationship between baseline vital signs and the development of bradycardia and/or hypotension is moderated by the dose of ketamine. Results obtained from this study may help responders and emergency care personnel to identify the patients that are likely to benefit from ketamine as an anesthetic agent.

show abstract

The effects of propofol-midazolam-ketamine co-induction on hemodynamic changes and catecholamine response

Cited by 13 publications

References 14 publications

Diagnostic Value and Safety of Emergency Single-Balloon Enteroscopy for Obscure Gastrointestinal Bleeding

Diagnostic Value and Safety of Emergency Single-Balloon Enteroscopy for Obscure Gastrointestinal Bleeding

Intubation of the Neurologically Injured Patient

Ketamine-induced Changes in Blood Pressure and Heart Rate in Pre-hospital Intubated Patients

Contact Info

Product

Resources

About