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[PMID]:28463863
[Au] Autor:Howard PK; Gisness CM
[Ad] Endereço:Emergency Services, University of Kentucky HealthCare, Lexington (Dr Kunz Howard); and Department of Emergency Medicine at Grady Hospital, Emory University, Atlanta, Georgia (Ms Gisness).
[Ti] Título:Is Subdissociative Ketamine As Safe and Effective As Morphine for Pain Management in the Emergency Department?
[So] Source:Adv Emerg Nurs J;39(2):81-85, 2017 Apr/Jun.
[Is] ISSN:1931-4493
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:: Review of recent evidence with translation to practice for the advanced practice nurse (APN) role is presented using a case study module for "Intravenous Subdissociative-Dose Ketamine Versus Morphine for Analgesia in the Emergency Department: A Randomized Controlled Trial." This prospective, randomized controlled inquiry enrolled 90 patients into 2 groups (ketamine vs. morphine) for patients seeking care in an emergency department with acute pain. Data regarding pain scores were collected at baseline, 15, 30, 60, 90, and 120 min. Study subjects reporting persistent pain could receive rescue analgesia with fentanyl. Initial pain scores for the subjects in each of the groups were comparable (ketamine: 8.6; morphine: 8.5). Pain management for the 2 groups revealed similar average doses (ketamine: 21.8 mg; morphine: 7.7 mg). Although subjects in both groups reported reduction in pain scores at 15 and 30 min, no clinical significance was found. Subjects experienced greater pain relief (pain score = 0) in the ketamine group at 15 min (percentage difference 31%; 95% confidence interval [13, 49]), yet this was not sustained at the 30-min interval. There were no serious or life-threatening adverse effects in either group. This study highlights the important role of the APN in providing quality care, communication about pain management, and related follow-up care.
[Mh] Termos MeSH primário: Ketamina/administração & dosagem
Morfina/administração & dosagem
Manejo da Dor/métodos
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Ketamina/efeitos adversos
Meia-Idade
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
690G0D6V8H (Ketamine); 76I7G6D29C (Morphine)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM; N
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.1097/TME.0000000000000145


  2 / 10756 MEDLINE  
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[PMID]:29406031
[Au] Autor:Hofstetter R; Fassauer GM; Link A
[Ad] Endereço:Institute of Pharmacy, Pharmaceutical and Medicinal Chemistry, University of Greifswald, Greifswald, Germany.
[Ti] Título:Supercritical fluid extraction (SFE) of ketamine metabolites from dried urine and on-line quantification by supercritical fluid chromatography and single mass detection (on-line SFE-SFC-MS).
[So] Source:J Chromatogr B Analyt Technol Biomed Life Sci;1076:77-83, 2018 Feb 15.
[Is] ISSN:1873-376X
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:On-line solid-phase supercritical fluid extraction (SFE) and chromatography (SFC) coupled to mass spectrometry (MS) has been evaluated for its usefulness with respect to metabolic profiling and pharmacological investigations of ketamine in humans. The aim of this study was to develop and validate a rapid, highly selective and sensitive SFE-SFC-MS method for the quantification of ketamine and its metabolites in miniature amounts in human urine excluding liquid-liquid extraction (LLE). Several conditions were optimized systematically following the requirements of the European Medicines Agency: selectivity, carry-over, calibration curve parameters (LLOQ, range and linearity), within- and between-run accuracy and precision, dilution integrity, matrix effect, and stability. The method, which required a relatively small volume of human urine (20 µL per sample), was validated for pharmacologically and toxicologically relevant concentrations ranging from 25.0 to 1000 ng/mL (r > 0.995). The lower limit of quantification (LLOQ) for all compounds was found to be as low as 0.5 ng. In addition, stability of analytes during removal of water from the urine samples using different conditions (filter paper or ISOLUTE® HM-N) was studied. In conclusion, the method developed in this study can be successfully applied to studies of ketamine metabolites in humans, and may pave the way for routine application of on-line SFE-SFC-MS in clinical investigations.
[Mh] Termos MeSH primário: Cromatografia com Fluido Supercrítico/métodos
Ketamina/urina
Espectrometria de Massas em Tandem/métodos
[Mh] Termos MeSH secundário: Estabilidade de Medicamentos
Temperatura Alta
Seres Humanos
Ketamina/química
Ketamina/metabolismo
Modelos Lineares
Reprodutibilidade dos Testes
Sensibilidade e Especificidade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
690G0D6V8H (Ketamine)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180207
[St] Status:MEDLINE


  3 / 10756 MEDLINE  
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[PMID]:28749092
[Au] Autor:Andrade C
[Ad] Endereço:Department of Psychopharmacology, National Institute of Mental Health and Neurosciences, Bangalore, India. candrade@psychiatrist.com.
[Ti] Título:Ketamine for Depression, 4: In What Dose, at What Rate, by What Route, for How Long, and at What Frequency?
[So] Source:J Clin Psychiatry;78(7):e852-e857, 2017 Jul.
[Is] ISSN:1555-2101
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Ketamine, administered in subanesthetic doses, is an effective off-label treatment for severe and even treatment-refractory depression; however, despite dozens of studies across nearly 2 decades of research, there is no definitive guidance on matters related to core practice issues. METHODS: This article presents a qualitative review and summary about what is known about ketamine dosing, rate of administration, route of administration, duration of treatment, and frequency of sessions. RESULTS: Ketamine is most commonly administered in the dose of 0.5 mg/kg, but some patients may respond to doses as low as 0.1 mg/kg, and others may require up to 0.75 mg/kg. The ketamine dose is conventionally administered across 40 minutes; however, safety and efficacy have been demonstrated in sessions ranging between 2 and 100 minutes in duration. Bolus administration is safe and effective when the drug is administered intramuscularly or subcutaneously. Whereas the intravenous route is the most commonly employed, safety and efficacy have been described with other routes of administration, as well; these include oral, sublingual, transmucosal, intranasal, intramuscular, and subcutaneous routes. Patients may receive a single session of treatment or a course of treatment during the acute phase, and treatment may rarely be continued for weeks to years to extend and maintain treatment gains in refractory cases. When so extended, the ideal frequency is perhaps best individualized wherein ketamine is dosed a little before the effect of the previous session is expected to wear off. CONCLUSIONS: There is likely to be a complex interaction between ketamine dose, session duration, route of administration, frequency of administration, and related practice. Until definitive studies comparing different doses, rates of administration, routes of administration, and other considerations are conducted, firm recommendations are not possible. From the point of view of clinical practicability, subcutaneous, intranasal, and oral ketamine warrant further study. If domiciliary treatment is considered, the risk of abuse must be kept in mind.
[Mh] Termos MeSH primário: Antidepressivos/administração & dosagem
Transtorno Depressivo Maior/tratamento farmacológico
Ketamina/administração & dosagem
[Mh] Termos MeSH secundário: Antidepressivos/efeitos adversos
Relação Dose-Resposta a Droga
Esquema de Medicação
Seres Humanos
Infusões Intravenosas
Injeções Intramusculares
Injeções Subcutâneas
Ketamina/efeitos adversos
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antidepressive Agents); 690G0D6V8H (Ketamine)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170728
[St] Status:MEDLINE


  4 / 10756 MEDLINE  
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[PMID]:29390298
[Au] Autor:Han D; Liu YG; Pan S; Luo Y; Li J; Ou-Yang C
[Ad] Endereço:Anesthesia Department, Capital Institute of Pediatrics affiliated Children's Hospital.
[Ti] Título:Comparison of hemodynamic effects of sevoflurane and ketamine as basal anesthesia by a new and direct monitoring during induction in children with ventricular septal defect: A prospective, randomized research.
[So] Source:Medicine (Baltimore);96(50):e9039, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Sevoflurane and ketamine are commonly used to obtain sedation and facilitate intravenous anesthetic induction in children undergoing cardiac surgery who are uncooperative. We used a new and direct systemic hemodynamic monitoring technique pressure recording analytical method and compared the hemodynamic effects of sevoflurane and ketamine to facilitate intravenous anesthetic induction. METHODS: Forty-four children with ventricular septal defect (2.2 ±â€Š1.2 years) were enrolled and randomized to receive sevoflurane (Group S) or intramuscular ketamine (Group K) for sedation, followed by intravenous midazolam-sufentanil induction and tracheal intubation. Recorded parameters included heart rate (HR), arterial pressures, stroke volume index (SVI), cardiac index (CI), systemic vascular resistance index (SVRI), the maximal slope of systolic upstroke (dp/dtmax) after sedation obtained with sevoflurane or ketamine, 1, 2, 5 minutes after midazolam-sufentanil, 1, 2, 5, and 10 minutes after tracheal intubation. Rate-pressure product (RPP) and cardiac power output (CPO) were calculated. RESULTS: As compared with Group S, Group K had faster decreases during intravenous anesthetic induction in arterial pressures (P < .01 for all), higher HR, arterial pressures, SVRI, dp/dtmax, RPP, lower SVI, CI, CPO (P < .05 for all) during the study period. CONCLUSION: As compared with sevoflurane, ketamine facilitated intravenous anesthetic induction exerts unfavorable effects on systemic hemodynamic and myocardial energetic in children with ventricular septal defect.
[Mh] Termos MeSH primário: Anestésicos Dissociativos/administração & dosagem
Anestésicos Inalatórios/administração & dosagem
Comunicação Interventricular/cirurgia
Hemodinâmica/efeitos dos fármacos
Ketamina/administração & dosagem
Éteres Metílicos/administração & dosagem
[Mh] Termos MeSH secundário: Pré-Escolar
Feminino
Seres Humanos
Lactente
Intubação Intratraqueal
Masculino
Estudos Prospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; OBSERVATIONAL STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Anesthetics, Dissociative); 0 (Anesthetics, Inhalation); 0 (Methyl Ethers); 38LVP0K73A (sevoflurane); 690G0D6V8H (Ketamine)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009039


  5 / 10756 MEDLINE  
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[PMID]:29206957
[Au] Autor:DeVylder J
[Ad] Endereço:University of Maryland, Baltimore.
[Ti] Título:Sleep as an Underused Target for Rapid Response in the Treatment of Depression and Suicidal Ideation.
[So] Source:Health Soc Work;41(3):211, 2016 Aug 01.
[Is] ISSN:0360-7283
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Anestésicos Dissociativos/uso terapêutico
Estimulação Encefálica Profunda
Depressão/terapia
Ketamina/uso terapêutico
Privação do Sono
Serviço Social
Ideação Suicida
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:LETTER
[Nm] Nome de substância:
0 (Anesthetics, Dissociative); 690G0D6V8H (Ketamine)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE
[do] DOI:10.1093/hsw/hlw031


  6 / 10756 MEDLINE  
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[PMID]:28452409
[Au] Autor:Grunebaum MF; Ellis SP; Keilp JG; Moitra VK; Cooper TB; Marver JE; Burke AK; Milak MS; Sublette ME; Oquendo MA; Mann JJ
[Ad] Endereço:Molecular Imaging and Neuropathology Division, Department of Psychiatry, Columbia University Medical Center (CUMC) and New York State Psychiatric Institute, New York, NY, USA.
[Ti] Título:Ketamine versus midazolam in bipolar depression with suicidal thoughts: A pilot midazolam-controlled randomized clinical trial.
[So] Source:Bipolar Disord;19(3):176-183, 2017 May.
[Is] ISSN:1399-5618
[Cp] País de publicação:Denmark
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To evaluate feasibility and effects of a sub-anesthetic infusion dose of ketamine versus midazolam on suicidal ideation in bipolar depression. Neurocognitive, blood and saliva biomarkers were explored. METHODS: Sixteen participants with bipolar depression and a Scale for Suicidal Ideation (SSI) score of ≥4 were randomized to ketamine (0.5 mg/kg) or midazolam (0.02 mg/kg). Current pharmacotherapy was maintained excluding benzodiazepines within 24 hours. The primary clinical outcome was SSI score on day 1 post-infusion. RESULTS: Results supported feasibility. Mean reduction of SSI after ketamine infusion was almost 6 points greater than after midazolam, although this was not statistically significant (estimate=5.84, SE=3.01, t=1.94, P=.074, 95% confidence interval ([CI)]=-0.65 to 12.31). The number needed to treat for response (SSI <4 and at least 50% below baseline) was 2.2, and for remission (SSI=0) was 3.2. The strongest neurocognitive correlation was between memory improvement on the Selective Reminding Test (SRT) and reduction in SSI score on day 1 after ketamine (ρ=-.89, P=.007). Pre- to post-infusion decrease in serum brain derived neurotrophic factor (BDNF) correlated with reduction in SSI from baseline to day 1 after ketamine (n=5, ρ=0.90, P=.037) but not midazolam (P=.087). CONCLUSIONS: The study demonstrated feasibility. Suicidal thoughts were lower after ketamine than after midazolam at a trend level of significance, likely due to the small pilot sample. Memory improvement and BDNF are promising biomarkers. Replication is needed in an adequately powered full-scale trial.
[Mh] Termos MeSH primário: Transtorno Bipolar
Ketamina
Memória/efeitos dos fármacos
Midazolam
Ideação Suicida
[Mh] Termos MeSH secundário: Adulto
Anestésicos Dissociativos/administração & dosagem
Anestésicos Dissociativos/efeitos adversos
Biomarcadores/análise
Transtorno Bipolar/diagnóstico
Transtorno Bipolar/tratamento farmacológico
Transtorno Bipolar/psicologia
Fator Neurotrófico Derivado do Encéfalo/análise
Relação Dose-Resposta a Droga
Método Duplo-Cego
Monitoramento de Medicamentos/métodos
Feminino
Moduladores GABAérgicos/administração & dosagem
Moduladores GABAérgicos/efeitos adversos
Seres Humanos
Ketamina/administração & dosagem
Ketamina/efeitos adversos
Masculino
Midazolam/administração & dosagem
Midazolam/efeitos adversos
Meia-Idade
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Anesthetics, Dissociative); 0 (Biomarkers); 0 (Brain-Derived Neurotrophic Factor); 0 (GABA Modulators); 0 (brain-derived neurotrophic factor, human); 690G0D6V8H (Ketamine); R60L0SM5BC (Midazolam)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1111/bdi.12487


  7 / 10756 MEDLINE  
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[PMID]:29390443
[Au] Autor:Ye F; Wu Y; Zhou C
[Ad] Endereço:Department of Anesthesiology, Xiangyang Central Hospital (The Affiliated Hospital of Hubei University of Arts and Science), Xiangyang, China.
[Ti] Título:Effect of intravenous ketamine for postoperative analgesia in patients undergoing laparoscopic cholecystectomy: A meta-analysis.
[So] Source:Medicine (Baltimore);96(51):e9147, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: We conducted a meta-analysis to assess the efficacy and safety of ketamine for reducing pain and narcotic use for patients undergoing laparoscopic cholecystectomy (LC). METHODS: PubMed, Embase, Web of science, Medline, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) were regarded as eligible in our study. After testing the heterogeneity across RCTs, data were aggregated for fixed/random effect model according to the I statistic. The meta-analysis was conducted using Stata 11.0 software. RESULTS: Five studies were included, with a total sample size of 212 patients. Current meta-analysis revealed that there were significant differences regarding postoperative pain score at 12 hours [standard mean difference (SMD) = -0.322, 95% confidence interval (95% CI): -0.594 to -0.050, P = .020], 24 hours (SMD = -0.332, 95% CI: -0.605 to -0.059, P = .017), and 48 hours (SMD = -0.340, 95% CI: -0.612 to -0.068, P = .014). Ketamine intervention was found to significantly decrease narcotic use at 12 hours (SMD = -0.296, 95% CI: -0.567 to -0.025, P = .033), 24 hours (SMD = -0.310, 95% CI: -0.581 to -0.039, P = .025), and 48 hours (SMD = -0.338, 95% CI: -0.609 to -0.066, P = .015). CONCLUSION: Ketamine appeared to significantly reduce postoperative pain and narcotic use following LC. On the basis of the current evidence available, higher quality RCTs are still required for further research.
[Mh] Termos MeSH primário: Analgésicos/uso terapêutico
Colecistectomia Laparoscópica
Ketamina/uso terapêutico
Dor Pós-Operatória/tratamento farmacológico
[Mh] Termos MeSH secundário: Uso de Medicamentos
Seres Humanos
Infusões Intravenosas
Entorpecentes/uso terapêutico
Medição da Dor
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Analgesics); 0 (Narcotics); 690G0D6V8H (Ketamine)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009147


  8 / 10756 MEDLINE  
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[PMID]:28993219
[Au] Autor:Ma J; Leung LS
[Ad] Endereço:Department of Physiology and Pharmacology, The University of Western Ontario, London N6A 5C1, Canada. Electronic address: jma2@uwo.ca.
[Ti] Título:Involvement of posterior cingulate cortex in ketamine-induced psychosis relevant behaviors in rats.
[So] Source:Behav Brain Res;338:17-27, 2018 Feb 15.
[Is] ISSN:1872-7549
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:The involvement of posterior cingulate cortex (PCC) on ketamine-induced psychosis relevant behaviors was investigated in rats. Bilateral infusion of muscimol, a GABA receptor agonist, into the PCC significantly antagonized ketamine-induced deficit in prepulse inhibition of a startle reflex (PPI), deficit in gating of hippocampal auditory evoked potentials, and behavioral hyperlocomotion in a dose dependent manner. Local infusion of ketamine directly into the PCC also induced a PPI deficit. Systemic injection of ketamine (3mg/kg,s.c.) induced an increase in power of electrographic activity in the gamma band (30-100Hz) in both the PCC and the hippocampus; peak theta (4-10Hz) power was not significantly altered, but peak theta frequency was increased by ketamine. In order to exclude volume conduction from the hippocampus to PCC, inactivation of the hippocampus was made by local infusion of muscimol into the hippocampus prior to ketamine administration. Muscimol in the hippocampus effectively blocked ketamine-induced increase of gamma power in the hippocampus but not in the PCC, suggesting independent generation of gamma waves in PCC and hippocampus. It is suggested that the PCC is part of the brain network mediating ketamine-induced psychosis related behaviors.
[Mh] Termos MeSH primário: Comportamento Animal/efeitos dos fármacos
Antagonistas de Aminoácidos Excitatórios/farmacologia
Giro do Cíngulo/fisiopatologia
Ketamina/farmacologia
Psicoses Induzidas por Substâncias/fisiopatologia
Reflexo de Sobressalto/efeitos dos fármacos
[Mh] Termos MeSH secundário: Estimulação Acústica
Animais
Relação Dose-Resposta a Droga
Potenciais Evocados Auditivos/efeitos dos fármacos
Giro do Cíngulo/efeitos dos fármacos
Hipocampo/efeitos dos fármacos
Hipocampo/fisiopatologia
Ratos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Excitatory Amino Acid Antagonists); 690G0D6V8H (Ketamine)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180207
[Lr] Data última revisão:
180207
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171011
[St] Status:MEDLINE


  9 / 10756 MEDLINE  
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[PMID]:28743507
[Au] Autor:Allen CA; Ivester JR
[Ad] Endereço:Office of Cheryl A. Allen, DNP candidate at Medical University of South Carolina, Charleston, South Carolina. Electronic address: alleca@musc.edu.
[Ti] Título:Ketamine for Pain Management-Side Effects & Potential Adverse Events.
[So] Source:Pain Manag Nurs;18(6):372-377, 2017 Dec.
[Is] ISSN:1532-8635
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:An old anesthetic agent, ketamine is finding new use in lower doses for analgesic purposes. There are concerns stemming from its potential side effects-specifically psychomimetic effects. These side effects are directly related to dose amount. The doses used for analgesic purposes are much lower than those used for anesthesia purposes. A literature review was performed to ascertain potential side effects and/or adverse events when using ketamine for analgesia purposes. The search included CINAHL, PubMed, and Ovid using the search terms "ketamine," "ketamine infusion," "pain," "adverse events," "practice guideline," and "randomized controlled trial." Searches were limited to full-text, peer-reviewed articles and systematic reviews. Initially 1,068 articles were retrieved. The search was then narrowed by using the Boolean connector AND with various search term combinations. After adjusting for duplication, article titles and abstracts were reviewed, leaving 25 articles for an in-depth analysis. Specific exclusion criteria were then applied. The literature supports the use of ketamine for analgesic purposes, and ketamine offers a nonopioid option for the management of some pain conditions. Because ketamine is still classified as an anesthetic agent, health care institutions should develop their own set of policies and protocols for the administration of ketamine. By using forethought and understanding of the properties of ketamine, appropriate care may be planned to mitigate potential side effects and adverse events so that patients are appropriately cared for and their pain effectively managed.
[Mh] Termos MeSH primário: Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/etiologia
Ketamina/efeitos adversos
Ketamina/farmacologia
Manejo da Dor/efeitos adversos
[Mh] Termos MeSH secundário: Analgésicos/efeitos adversos
Analgésicos/farmacologia
Analgésicos/uso terapêutico
Seres Humanos
Ketamina/uso terapêutico
Dor/tratamento farmacológico
Manejo da Dor/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Analgesics); 690G0D6V8H (Ketamine)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180206
[Lr] Data última revisão:
180206
[Sb] Subgrupo de revista:IM; N
[Da] Data de entrada para processamento:170727
[St] Status:MEDLINE


  10 / 10756 MEDLINE  
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[PMID]:29295971
[Au] Autor:Warner LL; Smischney N
[Ad] Endereço:Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA.
[Ti] Título:Special K with No License to Kill: Accidental Ketamine Overdose on Induction of General Anesthesia.
[So] Source:Am J Case Rep;19:10-12, 2018 Jan 03.
[Is] ISSN:1941-5923
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND Ketamine is used as an induction and sedation agent in emergency departments and operating rooms throughout the country. Despite its widespread clinical use, there are few cases of significant morbidity and mortality attributed to ketamine overdose in the clinical setting. CASE REPORT The anesthesia provider in the room was an oral maxillofacial surgeon who inadvertently took out a more highly concentrated bottle of ketamine that is typically used for pediatric patients. The patient received 950 mg (100 mg/ml concentration) of intravenous ketamine instead of the intended 95 mg (10 mg/ml concentration). After the ketamine was given, there were no signs to any involved provider that a mistake had occurred until the wake-up appeared to be unusually prolonged. CONCLUSIONS Despite this, the patient did not demonstrate any systemic effects such as hemodynamic or CNS perturbations other than prolonged awakening. This case highlights one (drug overdose) of many causes of delayed emergence from anesthesia and reminds the provider caring for the patient to be mindful of drug concentrations used when preparing to sedate a patient, as relying on effects of the parent drug is not always adequate.
[Mh] Termos MeSH primário: Anestesia Geral
Anestésicos Dissociativos
Recuperação Demorada da Anestesia/diagnóstico
Ketamina
Laringoscopia
Erros de Medicação
Prega Vocal/patologia
[Mh] Termos MeSH secundário: Idoso
Anestesia Geral/métodos
Anestésicos Dissociativos/efeitos adversos
Recuperação Demorada da Anestesia/terapia
Overdose de Drogas
Seres Humanos
Ketamina/efeitos adversos
Laringoscopia/métodos
Masculino
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anesthetics, Dissociative); 690G0D6V8H (Ketamine)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180205
[Lr] Data última revisão:
180205
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180104
[St] Status:MEDLINE



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