• Journal of Trauma and Injury
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• 제27권4호
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• pp.178-185
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• 2014

Purpose: The aim of this study was to assess the clinical efficacy of combined treatment with local anesthesia and ketamine procedural sedation for pediatric facial laceration repair in the Emergency Department (ED). Methods: Patients aged 1 to 5 years receiving ketamine for facial laceration repair were prospectively enrolled in a double-blind, randomized, and controlled study at an ED. All patients were to receive intravenous ketamine (2 mg/kg). The local anesthesia group (LA group) received a local anesthetic along with ketamine, whereas the no local anesthesia group (NLA group) received only ketamine. The total time of sedation, the patients' movements and groans, adverse events, and the satisfaction ratings of physicians, nurses, and parents were recorded. Results: A total of 186 patients were randomized (NLA group: 90, LA group: 96). The total time of sedation (30.5 minutes for the NLA group, 32.6 minutes for the LA group; p=0.660), patients' groans (26 (28.9%) versus 23 (24.0%); 0.446) and movements (27 (30%) versus 35 (36.5%); p=0.350) was not affected by the addition of local anesthesia. Other adverse events were similar between the two groups. Also, the satisfaction ratings of physicians (median 4 for the NLA group versus 4 for the LA group (p=0.796)), nurses (2 versus 2.5 (p=0.400)), and parents (4 versus 4 (p=0.199)) were equivalent between the two groups. Conclusion: In this study, we found that local anesthesia was not required along with ketamine sedation for pediatric facial laceration repair.

• Journal of Yeungnam Medical Science
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• 제41권3호
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• pp.207-212
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• 2024

Background: Myringotomy with tympanostomy tube insertion (MTI) is a superficial surgical procedure used to prevent hearing loss in children with serous otitis media. Intravenous anesthesia, often ketamine, is preferred for this procedure because of its ability to induce sedation without compromising airway reflexes. However, ketamine alone may be insufficient and potentially lead to spontaneous movement during surgery. This study evaluated the effectiveness of midazolam and fentanyl as adjuvants to ketamine in reducing spontaneous movement during MTI and enhancing the quality of recovery. Methods: This study involved two groups of 30 patients each: one group received intravenous ketamine (1.5 mg/kg) with an equal volume of normal saline (K group), while the other received a combination of midazolam, fentanyl, and ketamine (0.05 mg/kg, 1 ㎍/kg, and 1.5 mg/kg, respectively; MFK group). We assessed side effects, intraoperative patient movement, surgeon satisfaction, and emergence agitation scores. Results: The MFK group exhibited significantly lower scores for patient movement (p<0.01) and emergence agitation (p<0.01) and markedly higher surgeon satisfaction scores (p<0.01) than the K group. Conclusion: Administering a midazolam-fentanyl-ketamine combination effectively reduced spontaneous movement during surgery and emergence agitation during recovery without prolonging discharge times in children undergoing MTI.

• 한국임상수의학회지
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• 제17권2호
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• pp.395-402
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• 2000

흡입마취에서 마취를 유지하기 위해서는 도입 마취가 필수적이다. 도입 마취제는 작용시간이 짧고 기관 튜브를 용이하게 삽입할 수 있으며. 투여로 인한 생리적 영향이 적이야 한다 Acepromazine/ketamine(Group-AK) 병용 투여와 propofol(Group-P) 단독 투여로 마취 유도한 후 Enflurane으로 마취를 유지하였을 때 나타나는 생리적 변화를 비교하였다 체온, 호흡수, 평균 동맥압, Pa$CO_2$, PaO$_2$, pH, toe-wep pinch reflex 및 jaw tone reflex는 두 군간에서 유의성 있는 차이가 나타나지 않는다. Group-P은 group-AK보다 회복시간이 유의성 있게 짧았다 심박수는 group-AK군이 마취 추 5분에서 group-P보다 유의성 있게 증가하였다. 동성 빈 맥은 group-AK군에서는 5및 10분에 각각 2미터에서 관찰되었고 group-P에서는 5분에 2마리, 10분에 1마리가 관찰되었다. Acepromazine/ketamine propofol은 모두 enflurane 마취를 위한 도입마취제로서 양호한 효과를 나타내었다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제23권3호
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• pp.123-133
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• 2023

Sedation methods for dental treatment are increasingly explored. Recently, ketofol, which is a combination of ketamine and propofol, has been increasingly used because the advantages and disadvantages of propofol and ketamine complement each other and increase their effectiveness. In this review, we discuss the pharmacology of ketamine and propofol, use of ketofol in various clinical situations, and differences in efficacy between ketofol and other sedatives.

• 한국임상수의학회지
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• 제8권1호
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• pp.81-91
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• 1991

This study was carried out to investigate the effects of intravenous drip with ketamine hydrochloride and its application for control depth and maintenance of anesthesia in dogs. Changes of blood pressure, vital signs, blood gas and anesthetic state were observed in this study. The obtained were summerized as follows ; 1. Changes of blood pressure and heart rate after intravenous drip anesthesia with ketamine hydrochloride were observed with significant increase in all group ; group II (0.135m81k9/min), group III (0.269mg/kg/min) and group IV(0.538mg/kg/min). These conditions were maintained unchangeably until 160 minutes after administration in all group. This may be indicated that there were no side effects on account of ketamine accumulation. 2. There were irregular respiration, pain reflex, Jaw tone reflex and vomition probability in the anesthetic conditions of group II The anesthetic conditions of group III were rarely shown as mentioned above. Awakening time and recovery time of group H were more prolonged 21 minutes and 27 minutes respectively than those of group III. These experimental data suggested that the optimal dosage of intravenous drip anesthesia of ketamine Hcl was 0.269mg/kg/min.

• 대한치과마취과학회지
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• 제12권1호
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• pp.11-16
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• 2012

Background: The purpose of this study was to evaluate the safety and effectiveness of intravenous ketamine-midazolam sedation in uncooperative children and disabled people undergoing dental procedures. Methods: From September 2009 to January 2012, total 114 intravenous deep sedation were carried out using midazolam and ketamine at pediatric dentistry in Wonkwang University Daejeon Dental Hospital. Patients' dental charts and sedation records were retrospectively reviewed. Results: 103 cases were enrolled, divided into four groups. There were 22 children under five in group 1, 14 children over six years with severe anxiety in group 2, 34 disabled person in group 3 and 33 children over six years with surgical procedure in group 4. Carries treatment (56 cases) was the most common dental treatment. The highest ketamine usage was 4.15 mg/kg, the longest duration of dental treatment was 41.6 minutes in children under five group. Nausea and vomiting (16 cases) was the most common side effect. Conclusions: Intravenous ketamine-midazolam sedation appears safe and effective for uncooperative children and disabled person undergoing dental procedures. But, emesis is a common side effect of ketamine occurring with increasing age.

• The Korean Journal of Pain
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• 제21권3호
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• pp.248-251
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• 2008

The clinical syndrome of posttraumatic syringomyelia can complicate major spinal trauma and develops many months after spinal injury. The 50-90% of patients experienced the pain and especially the component of central pain. In patients with central pain following spinal cord injury, ketamine has been shown to be an effective analgesic. We report a case of posttraumatic syringomyelia in a 30-year-old woman who complained of central pain, weakness of both legs and dysesthesia. She had not responded to pulsed radiofrequency, or lidocaine infusion therapy, but a continuous intravenous infusion of ketamine, an N-methyl-D-asparate receptor antagonist, reduced her severe central pain. In conclusion, a ketamine infusion therapy resulted in a significant reduction of central pain without decreasing of motor power and function.

• 한국임상수의학회지
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• 제30권6호
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• pp.415-420
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• 2013

본 연구는 비글견에서 medetomidine-midazolam-ketamine 병용 마취 시 마취효과와 심혈관계 및 호흡기계에 미치는 영향을 평가하였다. Medetomidine 0.015 mg/kg (MMK-L군) 또는 medetomidine 0.02 mg/kg (MMK-H군)을 근육 주사한 후에 midazolam (0.3 mg/kg) 및 ketamine (5 mg/kg)을 근육 주사하였다. 마취유도 및 회복시간, 진정 및 진통점수, 심박수, 혈압, 직장 온도 및 호흡수 측정 및 동맥혈액가스분석을 실시하였다. 평균 마취 시간은 MMK-L군 ($52.4{\pm}11.08$분)과 MMK-H군($78.2{\pm}20.72$분)이 유의성 있게 달랐다. 두 군 모두에서 MMK 투여로 인해 개에서 만족스런 진정 및 진통을 얻을 수 있었다. 두 군 모두에서 심박수는 유의적인 감소를 보였으며 MMK-H군은 투여 후 5분부터 MMK-L군은 투여 후 20분부터 유의적인 심박수의 저하가 확인되었다. MMK 투여 후 두 군 모두에서 혈압은 증가하였으나 두 군사이의 유의적인 차이는 확인되지 않았다. 실험 결과 비글견에서 medetomidine-midazolam-ketamine 병용마취는 양호한 마취효과를 나타냈으며, 개의 MMK 병용마취에서 부작용을 최소화 하면서 만족할 만한 마취효과를 얻을 수 있는 medetomidine의 용량은 0.015 mg/kg 인 것으로 생각된다.

• 한국임상수의학회지
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• 제10권2호
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• pp.221-226
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• 1993

To study effective dossage and administration route for scaling, ketamine HCl/propionyl promazine HCl(ketamine) combination and tiletamine HCl/zolazepam HCl(zoletil) were administered in one hundred six dogs. The dogs were toy poodle, Yorkshire Terrier, Pekingese and Chihuahua. Scaling and polishing time, possible treatment time after the first injection of anesthetics, the number of anethesia added, presence of tongue movement during anesthesia, the presence of swaying sign during recovery and respiration were evaluated. The possible treatment time after the first Injection of anesthetic in toy poodle were 26.3${\pm}$3.0 minutes with intravenous(IM) treatment of ketamine 10mg/kg, and 21.4${\pm}$6.6 minutes with intramuscula(IM) treatment of zoletil 8mg/kg, In Yorkshire Terrier were 19.51: 1.7 minutes with IV treatment of ketamine 10mg/kg. 19.0${\pm}$5.2 minutes IM and 20.8${\pm}$6.1 minutes with IM treatment of zoletil 5mg/kg,24.8${\pm}$3,5 minutes with IM treatment of zoletil 8mg/kg. In pekingese were 27.5${\pm}$2.1 minutes with IM treatment of ketamine 10mg/kg,28.0${\pm}$4.2 minutes with IM treatment of zoletil 8mg/kg. In Chihuahua were 19.5${\pm}$1.9 minutes with IV treatment of ketamine 7mg/kg, 17.5${\pm}$1.7 minutes with IM treatment of ketamine 10mg/kg and 20.3${\pm}$3.8 minutes with IM treatment of zoletil 5mg/kg, 21.2${\pm}$5.5 minutes with IM treatment of zoletil 8mg/kg. Swaying sign was observed in all group during recovery time, espically, in toy poodle and Yorkshire Terrier which administered zoletil 8mg/kg IM showed more severe swaying sign. The present results suggested that injection of zoletil 8mg/kg IM might be relatively effective for scaling in Chihuahua Within 20 minutes treatment for scaling in Yorkshire Terrier and Chihuahua, IM treatment of ketamine 7 to 10mg/kg is recommended.

• Journal of Dental Anesthesia and Pain Medicine
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• 제21권5호
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• pp.413-429
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• 2021

Background: Migraine headaches are the second leading cause of disability worldwide and are responsible for significant morbidity, reduction in the quality of life, and loss of productivity on a global scale. The purpose of this systematic review and meta-analysis was to evaluate the efficacy of ketamine on migraines and other primary headache disorders compared to placebo and other active interventions, such as midazolam, metoclopramide/diphenhydramine, and prochlorperazine/diphenhydramine. Methods: An electronic search of databases published up to February 2021, including Medline via PubMed, EMBASE, Web of Science, and Cochrane Library, a hand search of the bibliographies of the included studies, as well as literature and systematic reviews found through the search was conducted to identify randomized controlled trials (RCTs) investigating ketamine in the treatment of migraine/headache disorders compared to the placebo. The authors assessed the risk of bias according to the Cochrane Handbook guidelines. Results: The initial search strategy yielded 398 unduplicated references, which were independently assessed by three review authors. After evaluation, this number was reduced to five RCTs (two unclear risk of bias and three high risk of bias). The total number of patients in all the studies was 193. Due to the high risk of bias, small sample size, heterogeneity of the outcomes reported, and heterogeneity of the comparison groups, the quality of the evidence was very low. One RCT reported that intranasal ketamine was superior to intranasal midazolam in improving the aura attack severity, but not duration, while another reported that intranasal ketamine was not superior to metoclopramide and diphenhydramine in reducing the headache severity. In one trial, subcutaneous ketamine was superior to saline in migraine severity reduction; however, intravenous (I.V.) ketamine was inferior to I.V. prochlorperazine and diphenhydramine in another study. Conclusion: Further double-blind controlled studies are needed to assess the efficacy of ketamine in treating acute and chronic refractory migraines and other primary headaches using intranasal and subcutaneous routes. These studies should include a long-term follow-up and different ketamine dosages in diagnosed patients following international standards for diagnosing headache/migraine.