Attempts to attenuate the cardiostimulatory effects of ketamine*

Lilburn, J.K.; Moore, J.; Dundee, John W.

doi:10.1111/j.1365-2044.1978.tb08385.x

Cited by 11 publications

(5 citation statements)

References 7 publications

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“…We found that 1.5 mg . kg-' lignocaine did not attenuate the hypertensive and tachycardic response to ketamine, which agrees with the findings of Lilburn et al (12) who used procainamide.…”

Section: Discussionsupporting

confidence: 91%

“…Fig. 1 shows the distribution of all rate pressure product values occurring throughout the study (n = 240) and these have been divided into values of 10 000; [10][11][12][13][14][15] 000; [15][16][17][18][19][20] 000 and > 20 000.…”

Section: Resultsmentioning

confidence: 99%

“…Previous attempts to attenuate the cardiostimulatory properties of ketamine have included studies using practolol, promethazine, hexamethonium, procainamide, verapamil and labetalol ( 12,13). Lignocaine has been widely used to obtund the hypertensive response to laryngoscopy and intubation, and when used in a dose of 1.5 mg .…”

Section: Discussionmentioning

confidence: 99%

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The cardiovascular response to ketamine: the effects of clonidine and lignocaine

Munro

Sleigh

Paxton

1993

Acta Anaesthesiol Scand

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The effectiveness of clonidine or lignocaine in reducing the cardiostimulatory effects of ketamine was studied. A double-blind, randomized design was used in three groups of 20 patients each, of ASA grade 1 or 2 presenting for minor elective surgery. The clonidine group received 0.3 mg clonidine orally with the premedication while the lignocaine group received 1.5 mg.kg-1 lignocaine prior to induction. The third group formed the controls. All patients were induced with 2 mg.kg-1 ketamine intravenously. The systolic blood pressure in the clonidine group was significantly lower than that of both the control and lignocaine groups throughout the study (P < 0.05). It was concluded that clonidine was effective in reducing the hypertensive response to ketamine, whereas lignocaine had no effect.

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“…We found that 1.5 mg . kg-' lignocaine did not attenuate the hypertensive and tachycardic response to ketamine, which agrees with the findings of Lilburn et al (12) who used procainamide.…”

Section: Discussionsupporting

confidence: 91%

Section: Resultsmentioning

confidence: 99%

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The cardiovascular response to ketamine: the effects of clonidine and lignocaine

Munro

Sleigh

Paxton

1993

Acta Anaesthesiol Scand

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“…Small doses of either midazolam and propofol can be administered to attenuate the adverse psychotomimetic reactions produced by ketamine. [ 18 ] Dexmedetomidine (1 μg/kg I.V.) significantly decreases anxiety levels and reduces the requirement for supplemental analgesic medications when given before intravenous regional anesthesia.…”

Section: Discussionmentioning

confidence: 99%

A study to compare the overall effectiveness between midazolam and dexmedetomidine during monitored anesthesia care: A randomized prospective study

et al. 2015

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Background:Monitored anesthesia care (MAC) combines intravenous sedation along with local anesthetic infiltration or nerve block. Several drugs have been used for MAC, but all are associated with complications. Dexmedetomidine is a selective α2-adrenoceptor agonist with both sedative and analgesic properties and is devoid of respiratory depressant effects. Its short elimination half-life makes it an attractive agent for sedation during MAC.Aim:Comparative evaluation of dexmedetomidine and midazolam for MAC.Methods:In this prospective, randomized, double-blind study, 50 American Society of Anesthesiologist I and II patients undergoing a surgical or diagnostic procedure of <1 h requiring MAC were enrolled. Dexmedetomidine-ketamine (Group “KD”) patients (n = 25) received intravenous (I.V.) dexmedetomidine 1 mcg/kg over 10 min followed by 0.5 mg/kg of I.V. ketamine. Midazolam-ketamine patients (n = 25) received I.V. midazolam 0.05 mg/kg over 10 min followed by 0.5 mg/kg of I.V. ketamine to get a targeted level of sedation (≤4 using Observer's Assessment of Alertness/Sedation Scale score). Inadequate sedation (e.g., 15% increase in mean arterial blood pressure or heart rate, decrease in degree of calmness, increase in respiratory rate, physical movement) was treated by a ketamine bolus of 0.5 mg/kg as a rescue analgesia.Statistical Analysis:The statistical tests used in the study are unpaired Student's t-test for continuous variables and Chi-square test for categorical variables. Mann–Whitney test was used to assess the patient and surgeon satisfaction. Data were expressed as mean ± standard deviation. Value of P < 0.05 is considered significant and P < 0.0001 as highly significant.Results:Clinically desired sedation and analgesia was achieved earlier and better with dexmedetomidine. Patients and surgeons satisfaction were significantly higher with dexmedetomidine. The requirement of additional sedation and analgesia was less in dexmedetomidine (KD) group.Conclusion:During MAC dexmedetomidine provides better sedation and analgesia than midazolam.

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“…Nightmares may occur during recovery in up to 50% of adult^,^ but can be partly avoided by benzodiazepine premedication. [1][2][3][4][5][6][7][8][9][10][11][12][13][14] It increases muscle tone and is therefore unsuitable for procedures requiring muscle relaxation such as the reduction of fractures. Ketamine may cause a rise in intracranial and intraocular pressure, rendering it unsuitable for some patients or for neurological or ophthalmological procedures.…”

Section: Mg/kg) Causes No Greater Fall In Blood Pressure Than Most Otmentioning

confidence: 99%

Intravenous anaesthetics for short procedures

1983

DTB

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Attempts to attenuate the cardiostimulatory effects of ketamine*

Cited by 11 publications

References 7 publications

The cardiovascular response to ketamine: the effects of clonidine and lignocaine

The cardiovascular response to ketamine: the effects of clonidine and lignocaine

A study to compare the overall effectiveness between midazolam and dexmedetomidine during monitored anesthesia care: A randomized prospective study

Intravenous anaesthetics for short procedures

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