An appraisal of ketamine in the dressing of burns

Ward, Christopher; Diamond, A.

doi:10.1136/pgmj.52.606.222

Cited by 20 publications

(8 citation statements)

References 6 publications

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“…Bei absehbar schwierigen Intubationsbedingungen, Apnoephasen bei vorhergehenden Verbandwechseln unter Opioidanalgesie oder Kreislaufinsuffizienz wird daher aufgrund der hohen therapeutischen Breite hinsichtlich einer Atemdepression und der Kreislaufstabilität [19,24,67] …”

Section: Verbandwechselunclassified

Das Verbrennungstrauma –Teil 2

2009

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After initial stabilization of burn victims at the scene and in the trauma room, a tight cooperation and communication between anesthesiologists, plastic surgeons and intensive care specialists is needed for further therapy. Interdisciplinary communication about preoperative planning, timing of necrectomy and intensive care therapy is vital regarding functional and aesthetic outcome and survival rate. During burn surgery attention has to be paid to excessive blood loss and the danger of hypothermia. The main problems of intensive care therapy involve the evaluation of volume status, high demands for analgesia and sedation, high incidence of septic multiorgan failure and therapy and prophylaxis of the effects of hypermetabolism.

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Section: Verbandwechselunclassified

Das Verbrennungstrauma –Teil 2

2009

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“…The most painful part of burn-wound management occurs during the handling of the patient for dressing changes during which additional analgesia and sedation are required 1,3,4 . Traditionally, opioids have been the mainstay of pain management 1,3,14 . It is evident, however, that in spite of high doses of opioids, patients still experience pain during procedures 1,3,14 .…”

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confidence: 99%

“…Traditionally, opioids have been the mainstay of pain management 1,3,14 . It is evident, however, that in spite of high doses of opioids, patients still experience pain during procedures 1,3,14 . Opioid resistance is a well-recognised feature of neuropathic pain 1 , which is the result of secondary central nervous system dysfunction caused by prolonged pain stimulation 6 .…”

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confidence: 99%

“…It is a hypnotic, analgesic, amnesiac and sedative that has been used in the treatment of burn wounds since 1973 7,15 . Ketamine is a noncompetitive NMDA receptor antagonist 5 that has been shown to be very effective in the management of pain for dressing changes when given intravenously or intramuscularly prior to bandage changes 1,3,14 . A dose of 2 mg/kg of ketamine combined with diazepam or midazolam has been used intravenously in human burn-wound patients 1,3,14 .…”

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confidence: 99%

“…Ketamine is a noncompetitive NMDA receptor antagonist 5 that has been shown to be very effective in the management of pain for dressing changes when given intravenously or intramuscularly prior to bandage changes 1,3,14 . A dose of 2 mg/kg of ketamine combined with diazepam or midazolam has been used intravenously in human burn-wound patients 1,3,14 . Ketamine has been used orally in the treatment and management of paediatric burn-wound patients at a dose of 10 mg/kg given 20 min before the procedure 4 .…”

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confidence: 99%

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Ketamine hydrochloride - an adjunct for analgesia in dogs with burn wounds : clinical communication

Joubert¹

1998

J. S. Afr. Vet. Assoc.

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The management of pain in patients with burn wounds is complex and problematic. Burn-wound pain is severe, inconsistent and underestimated. Patients experience severe pain, especially during procedures, until wound healing has occurred. A multi-modality approach is needed for effective management of pain, which requires an understanding of the mechanisms of pain. Altered pharmacokinetics and pharmacodynamics in burn-wound patients makes drug actions unpredictable. Opioids alone are seldom sufficient for pain control. The multi-modality approach includes the use of opioids and non-steroidal antiinflammatory, anxiolytic and alternative drugs. Ketamine has been found to be a useful agent for analgesia in burn-wound patients; a dose of 10 mg/kg qid per os was found to be an effective adjunct to pain therapy.

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