• Title/Summary/Keyword: ketamine

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Management of Spinal Cord Injury Pain with Small Divided Doses of Intravenous Ketamine -Two case reports- (케타민의 소량 분할 정주에 의한 척수손상 환자의 통증 관리 -증례 보고-)

  • Han, Chan-Soo;Park, Jin-Hyeok;Kim, Jin-Soo;Kim, Il-Ho;Kim, Yu-Jae;Kim, Chun-Sook;Ahn, Ki-Ryang
    • The Korean Journal of Pain
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    • v.12 no.1
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    • pp.123-127
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    • 1999
  • Chronic pain is a frequent complication after spinal cord injury. Various medical and surgical approaches have been applied for management of spinal cord injury pain but none of them are definitive. The N-methyl-D-Aspartate (NMDA) receptor antagonist, ketamine has been reported to have a significant effect in the management of neuropathic pain. We used small divided doses of intravenous ketamine (30 mg divided by 6 equals 5 mg, 5 min interval) in spinal cord injury patients suffering from chronic pain, and accomplished significant pain relief without side effects.

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Comparison of Tiletamine-zolazepam, Tiletamine-zolazepam-xylazine and Ketamine-xylazine anesthesia in dogs (개에서 Tiletamine-zolazepam, Tiletamine-zolazepam-xylazine 및 Ketamine-xylazine의 마취효과)

  • Chang, Hye-sook;Jang, In-ho
    • Korean Journal of Veterinary Research
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    • v.38 no.2
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    • pp.401-412
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    • 1998
  • This study was conducted to compare the anesthetic effects of intravenous tiletamine-zolazepam(TZ, 7mg/kg TZ), tiletamine-zolazepam-xylazine(TZX, 7mg/kg TZ and 1.1mg/kg X) and ketamine-xylazine(KX, 10mg/kg K and 1.1mg/kg X). Fifteen mixed-breed healthy dogs($3.5{\pm}1.0kg$) were randomly assigned to the three treatment groups(TZ, TZX, KX) with 5 dogs in each group. The mean surgical anesthesia time was $25.6{\pm}4.2$, $62.6{\pm}6.2$ and $21.0{\pm}3.7$ min in TZ-, TZX- and KX-anesthetized dogs, respectively. The duration of the loss of response to toe-web needle prick and to visceral pain was significantly increased in the TZX group with $40.0{\pm}15.8$ min and $44.0{\pm}5.5$ min, respectively(p<0.01). Heart rate decreased significantly below baseline in TZX and KX groups(p<0.05, p<0.01) whereas it increased above baseline in TZ group. Respiratory rate remained unchanged or increased above baseline in TZ group, but decreased significantly from 10 to 30 min in TZX(p<0.01, p<0.05) and at 10 min in KX group(p<0.05). Body temperature decreased significantly below baseline in all three groups(p<0.01, p<0.05). Hematologic(PCV, RBC, WBC) and serum chemistry values(GOT, GPT, BUN, creatinine, total protein, glucose) were monitored before anesthesia, after recovery from anesthesia and 1, 3 and 7 days postanesthesia. All hematologic values remained generally within normal ranges, and GOT, GPT, BUN, creatinine and total protein values were within normal ranges during the period. Glucose values for TZX and KX groups increased greatly after recovery from anesthesia. We conclude that tiletamine-zolazepam-xylazine provides effective surgical anesthesia in dogs and in many cases may be preferable to conventional ketamine-xylazine regimen.

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Comparative evaluation of intranasal midazolam-ketamine, dexmedetomidine-ketamine, midazolam-fentanyl, and dexmedetomidine-fentanyl combinations for procedural sedation and analgesia in pediatric dental patients: a randomized controlled trial

  • Abhilasha Agarwal;Afroz Alam Ansari;Rajendra Nath;Rakesh Kumar Chak;Rajeev Kumar Singh;Richa Khanna;Prem Raj Singh
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.23 no.2
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    • pp.69-81
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    • 2023
  • Background: In order to assess the effectiveness of various analgesio-sedative combinations for pain relief and sedation in pediatric dental patients, a thorough evaluation of clinical studies and patient outcomes is necessary. Methods: A total of 128 healthy, uncooperative pediatric dental patients were randomly allocated to receive one of the four combinations of drugs via the intranasal (IN) route: Group I received midazolam-ketamine (MK), Group II received dexmedetomidine-ketamine (DK), Group III received midazolam-fentanyl (MF), and Group IV received dexmedetomidine-fentanyl (DF) in a parallel-arm study design. The efficacy and safety of the combinations were evaluated using different parameters. Results: The onset of sedation was significantly faster in the DF group than in the DK, MF, and MK groups (P < 0.001). The depth of sedation was significantly higher in the DK and DF groups than in the MK and MF groups (P < 0.01). DK and DF produced significant intra- and postoperative analgesia when compared with combinations of MK and MF. No significant adverse events were observed for any of the combinations. Conclusions: The DK and DF groups showed potential as analgesio-sedatives in view of their anxiolytic and analgesic effects.

Effect of Chemical Restraint Drugs on Gastroduodenal Transit Time of Barium Sulfate in Cats (고양이에서 진정제 및 마취제가 Barium Sulfate의 위 십이지장 통과시간에 미치는 영향)

  • Yun Jeong-Hee;Sung Jai-Ki
    • Journal of Veterinary Clinics
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    • v.6 no.1
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    • pp.173-184
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    • 1989
  • The effect of propionylpromazine, acepromazine maleate, ketamine HCI, xylazine HCI, and pentobarbital sodium as chemical restraint drugs on the transit time of barium sulfate through the stomach and duodenum in 24 healthy cats was investigated. In the present study, propionylpromazine, acepromazine maleate, and ketamine HCI did not reveal significant effect on the gastroduodenal transit time, but xylazine HCI and pentobarbital sodium pro-longed the gastroduodenal transit time markedly compared with control group. Therefore it is concluded that propionylpromazine, acepromazine maleate, and ketamine HCI could be selected for upper gastrointestinal radiographs. but xylazine HCI and pentobarbital sodium should be avoided.

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Other N-Methyl-D-Aspartate (NMDA) Receptor Antagonists with a Rapid Onset of Action and Less Side Effect in the Treatment of Depression (우울증 치료에서 빠른 효과와 적은 부작용을 가진 새로운 N-Methyl-D-Aspartate(NMDA) 수용체 길항제)

  • Choi, Bum-Sung;Lee, Hwa-Young
    • Korean Journal of Biological Psychiatry
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    • v.22 no.4
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    • pp.149-154
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    • 2015
  • Mood disorder is a common psychiatric illness with a high lifetime prevalence in the general population. Many prescribed antidepressants modulate monoamine neurotransmitters including serotonin, norepinephrine and dopamine. There has been greater focus on the major excitatory neurotransmitter in the human brain, glutamate, in the pathophysiology and treatment of major depressive disorder (MDD). Recently, ketamine, an N-methyl-D-aspartate receptor antagonist, has received attention and has been investigated for clinical trials and neurobiological studies. In this article, we will review the clinical evidence for glutamatergic dysfunction in MDD, the progress with ketamine as a rapidly acting antidepressant, and other N-methyl-D-aspartate receptor antagonist for treatment-resistant depression.

Effects of Anesthetics on Somatosensory Evoked Potentials (SEPs) in Dogs (마취제가 개의 Somatosensory Evoked Potentials (SEPs)에 미치는 영향)

  • Hong, Yeon-Jung;Jeong, Seong-Mok;Nam, Tchi-Chou
    • Journal of Veterinary Clinics
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    • v.19 no.3
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    • pp.277-282
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    • 2002
  • This study was designed to evaluate the effects of anesthetics on waveform of SEPs and to authorize possible anesthetic protocol for measurement of the somatosensory evoked potentials (SEPs). Thirteen anesthetic methods were used. The SEPs were recorded on two channels (between the 5th and 6th lumbar vertebra as the channel 1 and between the 11th and 12th thoracic vertebra as the channel 2) following stimulation of posterior tibial nerve. ID analyze SEPs wave, latency and conduction velocity were measured. Among thirteen anesthetic methods, standard SEPs waveforms were observed in dogs anesthetized with following six methods: Acepromazine + Thiepfntal Na + Isoflurane, Acepronazine + Propofol + Isoflurane, Diazepam + Xylazine, Xylazine + Ketamine, Acepromazine + Propofol infusion and Propofol infusion. Above six methods could be used with sufficient anesthetic depth. The differences of latency and conduction velocity among six groups were minimal compared to general waveform of SEPs. These results indicate that the six anesthetic methods can be used for recording SEPs in the dog. In particular, Diazepam + Xylazine and XylaBine + Ketamine as injectable anesthesia are considered more convenient than other four methods in veterinary medicine.

Epidural Analgesia Using High Dose Morphine in a Terminal Lung Cancer Patient -A case report- (고용량 모르핀의 지속적 경막외주입에 의한 암성 통증 조절 -증례보고-)

  • Lee, Ji Yeon;Shinn, Helen Ki;Kim, Tae Jung;Cho, Young Deog;Song, Ha Na;Yang, Chun Woo
    • The Korean Journal of Pain
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    • v.19 no.1
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    • pp.96-100
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    • 2006
  • Pain control is very important in managing terminal cancer patients and there are several modalities to alleviate their pain. A high dosage of epidural morphine is effective to control terminal cancer pain. Furthermore, to decrease the amount of morphine, adding an alternative adjuvant like ketamine to the morphine regimen is considered helpful for controlling the pain of a terminal cancer patient. A 45 year old male patient with terminal lung cancer had neck pain that was caused by multiple bone metastases. Continuous epidural block was started with 2 mg/day of morphine and the dosage was gradually increased to 90 mg/day in 86 days. 30 mg/day of ketamine was then added to it. Overall, the morphine and ketamine dosages were increased to 564 mg/day and 140 mg/day, respectively, in 11 months until the patient expired. In this case, the high dosage of epidural morphine, 580 mg/day, was administered to control cancer pain without any severe adverse effects.

The Effects of Thiopental, Propofol, Etomidate and Diazepam-Ketamine Combination on Isoflurane Anesthesia in Dogs (개의 Isoflurane 흡입마취 시 Thiopental, Propofol, Etomidate 및 Diazepam-Ketamine 병용투여의 영향)

  • Lee, Jae-Yeon;Jee, Hyun-Chul;Kim, Myung-Cheol;Jeong, Seong-Mok
    • Journal of Veterinary Clinics
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    • v.23 no.4
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    • pp.447-452
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    • 2006
  • This study was performed to compare propofol, thiopental, etomidate and diazepam plus ketamin as induction agents for the isoflurane anesthesia in dogs. Experimental groups were divided into low groups (thiopental group: thiopental 15 mg/kg IV, propofol group: propofol mg/kg IV, etomidate group: etomidate 1.5 mg/kg IV, DZP+KET group: diazepam 0.5 mg/kg + ketamine 5 mg/kg, IV) and each group was consisted of 4 dogs. Cardiorespiratory changes (heart rate, $SpO_2$, respiratory rate, End-tidal $CO_2$ and body temperature), blood serum chemistry values (alkaline phosphatase, alanine aminotransforase, and total protein), and recovery and walking time were measured. The end tidal carbon dioxide level was significantly increased in the thiopental group (P<0.05). Heart rate and respiratory rate higher in the DZP+KET groups. There was hypothermia in all groups and significant decrease in body temperature was showed in thiopental group (p<0.05). Mean arousal time and mean walking time were significantly longer in thiopental group (P<0.05). Cardiovascular stimulating effects were minimal in etomidate group. Etomidate provides uneventful and rapid recovery.

Monitoring Differences in Vaginal Hemodynamic and Temperature Response for Sexual Arousal by Different Anesthetic Agents Using an O ptical Probe

  • Jeong, Hyeryun;Seong, Myeongsu;Park, Kwangsung;Kim, Jae Gwan
    • Current Optics and Photonics
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    • v.4 no.1
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    • pp.57-62
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    • 2020
  • The selection of anesthetic agent is important in preclinical studies, since each agent affects the systemic hemodynamics in different ways. For that reason, we hypothesized that different anesthetic agents will result in different vaginal hemodynamic response and temperature during sexual arousal, in an animal model. To validate the hypothesis, animal experiments were performed using female rats with two anesthetic agents widely used in preclinical studies: ketamine and isoflurane. Our previously developed near-infrared-spectroscopy-based probe was used to measure the changes of oxyhemoglobin (OHb), deoxyhemoglobin (RHb), and total hemoglobin (THb) concentrations along with temperature from the animal vaginal wall. As a control, saline was administered to both isoflurane- and ketamine-anesthetized animals, and did not show any significant changes in OHb, RHb, THb, or temperature. However, an administration of apomorphine (APO, 80 ㎍/kg) induced increases of OHb (63 ± 28 μM/DPF), RHb (35 ± 20 μM/DPF), and THb (98 ± 49 μM/DPF) in ketamine-anesthetized animals, while decreases of OHb (52 ± 76 μM/DPF) and THb (38 ± 30 μM/DPF) and an increase of RHb (28 ± 51 μM/DPF) were found in isoflurane-anesthetized animals. The vaginal temperature decreased from the baseline in both ketamine-(0.42℃) and isoflurane-(1.22℃)anesthetized animals. These results confirmed our hypothesis, and suggest that a preclinical study monitoring hemodynamic responses under anesthesia should employ an appropriate anesthetic agent for the study.