The multiple faces of ketamine in anaesthesia and analgesia

Natoli, Silvia

doi:10.7573/dic.2020-12-8

Cited by 16 publications

(15 citation statements)

References 130 publications

(119 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Its characteristics that mimic the response to vasopressor effects confer beneficial hemodynamic effects in addition to analgesia and sedation. 2,9 This was also seen in this case, in which a septic shock patient with the addition of a low dose of 0.1 mg/kgBW/hour ketamine could act as analgesia without worsening the patient's hemodynamics.…”

Section: Discussionsupporting

confidence: 63%

See 1 more Smart Citation

Continuous Intravenous Ketamine for Management of Acute Pain Postoperative Laparotomy with Septic Shock: A Case Report

Nugrainy

Tan

2022

JACR

View full text Add to dashboard Cite

Introduction: Ketamine used for patients in the intensive care unit provides a combination of sedation and analgesia as well as a beneficial effect on hemodynamics. This study aims to describe the use of continuous intravenous ketamine as postoperative laparotomy pain management in septic shock. Case presentation: A man, 55 years old, came to the emergency room with complaints of abdominal pain accompanied by bloating, nausea, and vomiting. From the anamnesis and physical examination and support, a diagnosis of peritonitis generalisata et causa hernia suspect incarceration was found. In postoperative observation, vital sign examination showed blood pressure 80/50, pulse 128x/minute, respiratory rate 24x/minute, temperature 37.7ºC, and numeric rating scale 5/10. The treatment the patient got was simple oxygen mask 6-7 L/ minutes, IVFD ringer lactate 3000 cc/24 hours, intravenous ceftriaxone 1gr/12 hours, intravenous metronidazole 500 mg/8 hours, norepinephrine 0.15-0.2 mcg/kg/minute titration, dobutamine 7.5 mcg/kg/minute titration, fentanyl 0.5 mcg/kg/hour titration, ketamine 0.08-0.1 mg/kg/hour and intravenous paracetamol drips 1gr/ 6 hours. The patient experienced improvement and decreased the need for postoperative fentanyl analgesia from 0.5 mcg to 0.3 mcg/kg/hour. Conclusion: The addition of continuous ketamine for acute pain management has been shown to reduce opioid requirements in critically ill patients. The combination of low doses of ketamine together with continuous opioids resulted in a lower pain scale and decreased cumulative use of opioids.

show abstract

Section: Discussionsupporting

confidence: 63%

“…Previous research related to the addition of ketamine found that the combination of ketamine-opioid significantly reduced the pain scale score, cumulative morphine consumption, and desaturation events in postoperative patients. 9,10 The use of ketamine in mechanically ventilated patients has shown an increasing trend.…”

Section: Discussionmentioning

confidence: 99%

Continuous Intravenous Ketamine for Management of Acute Pain Postoperative Laparotomy with Septic Shock: A Case Report

Nugrainy

Tan

2022

JACR

View full text Add to dashboard Cite

show abstract

“…The use of ketamine as an adjunct to multimodal analgesia is well described [2, 20–22]. The advantages include: decreased opioid consumption and tolerance; improved postoperative analgesia; reduced nausea and vomiting; reduction in hyperalgesia; and improved long‐term persistent post‐surgical pain profiles.…”

Section: Discussionmentioning

confidence: 99%

Compatibility and stability of an admixture of multiple anaesthetic drugs for opioid‐free anaesthesia

et al. 2022

View full text Add to dashboard Cite

The ability to combine and use drugs in a single infusion device may be useful in resource-limited settings. This study examined the chemical stability of an opioid-sparing mixture of ketamine, lidocaine and magnesium sulphate when combined in a single syringe. High-performance liquid chromatography and atomic absorption spectrophotometry were performed on six syringes containing the three-drug mixture. Since most opioid-sparing techniques typically rely on a 24-hour infusion regime, we tested stability at the initial admixing and 24 hours later. Stability was defined as a measured drug concentration within 10% of expected, with the absence of precipitation or pH alterations. Pharmacokinetic simulations were conducted to further show that the achieved plasma drug concentrations were well within an effective analgesic range. All mixed drug concentration measurements were within the required 10% reference limit. No obvious precipitation or interaction occurred, and pH remained stable. Drug stability was maintained for 24 hours. Pharmacokinetic simulations showed that ketamine and lidocaine were within their minimum analgesic effect concentrations. Our results show that this three-drug mixture is chemically stable for up to 24 hours after mixing, with a pharmacokinetic simulation illustrating safe, clinically useful predicted plasma concentrations when using the described admixture.

show abstract

“…It has long been used in premedication. It can be administered orally (5–8 mg/kg), intramuscularly (4–6 mg/kg) or iv (1–2 mg/kg) [ 64 ]. Benefits include its analgesic properties and the ability to cause sedation not associated with respiratory depression [ 65 ].…”

Section: Perioperative Anesthetic Phasesmentioning

confidence: 99%

The Perioperative Anesthetic Management of the Pediatric Patient with Special Needs: An Overview of Literature

Ciccozzi

Pizzi²,

Vittori

et al. 2022

Children

View full text Add to dashboard Cite

The perioperative management of pediatric patients with psycho-physical disorders with related relational and cognitive problems must be carefully planned, in order to make the entire hospitalization process as comfortable and as less traumatic as possible. This article reports an overview of the anesthetic management of non-cooperative patients between 6 and 14 years old. The pathologies most frequently responsible for psycho-physical disorders can be summarized into three groups: (1) collaboration difficulties (autism spectrum disorders, intellectual impairment, phobia); (2) motor dysfunction (cerebral palsy, epilepsy, other brain pathologies, neuromuscular disorders), and (3) craniofacial anomalies (Down syndrome, other genetic syndromes). Anesthesia can be performed safely and successfully due to careful management of all specific problems of these patients, such as a difficult preoperative evaluation (medical history, physical examination, blood sampling, evaluation of vital parameters and predictive indices of difficult airway) and the inapplicability of a “standard” perioperative path (timing and length of the hospitalization, anesthetic premedication, postoperative management). It is necessary to ensure a dedicated perioperative process that is safe, comfortable, tailored to specific needs, and as less traumatic as possible. At the same time, all necessary precautions must be taken to minimize possible complications.

show abstract

The multiple faces of ketamine in anaesthesia and analgesia

Cited by 16 publications

References 130 publications

Continuous Intravenous Ketamine for Management of Acute Pain Postoperative Laparotomy with Septic Shock: A Case Report

Continuous Intravenous Ketamine for Management of Acute Pain Postoperative Laparotomy with Septic Shock: A Case Report

Compatibility and stability of an admixture of multiple anaesthetic drugs for opioid‐free anaesthesia

The Perioperative Anesthetic Management of the Pediatric Patient with Special Needs: An Overview of Literature

Contact Info

Product

Resources

About