Comparison of the effects of four subdoses of dextroketamine to reduce pain during posterior brachial plexus block: A randomized double blind study

Imbellon, Luiz Eduardo; Gouveia, Marildo A.; Filho, Geraldo Borges de Morais

doi:10.4103/0259-1162.186590

Cited by 5 publications

(5 citation statements)

References 17 publications

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“…11 Our group has long experience with the technique using nerve stimulation with several published articles. 5,8 This fact was confirmed in this series of 50 patients with 80% of the first attempts to be successful in locating the brachial plexus, similar results and those of other authors. 11 In another article with catheter insertion through the needle, neck pain was caused by penetrating the extensor paraspinal muscles of the neck.…”

Section: Discussionsupporting

confidence: 87%

“…All patients were initially sedated with intravenous midazolam 1 mg and before placement in the puncture position for blockade with 0.1μg/kg dextroketamine. 8 Immediately after placement in the sitting position the puncture site was identified and marked. With aseptic condition, the plexus block was performed with a needle A100 needle gauge 21G with a cutting bevel of 30˚ with 1 mL of 1% lidocaine infiltration, coupled to a NE.…”

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confidence: 99%

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Clinical efficacy of the brachial plexus via posterior approach for orthopedic surgery

Imbelloni¹,

Teixeira²,

Lima³

et al. 2020

JACCOA

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sufficient sedation to maintain the patient in position for posterior brachial plexus block and for the relief of pain in 55% of them during the procedure, without hemodynamic variation. 8 This prospective and observational study was performed to evaluate the clinical effectiveness of posterior brachial plexus access with a single injection of the combination of lidocaine and enantiomeric excess levobupivacaine with neurostimulator in patients undergoing clavicle, shoulder and proximal chair procedures of beach associated with general anesthesia. Methods The study was submitted and approved by the Ethics Research Committee (Number 05787/2014) and all patients were explained the method and obtained their consent by signing the informed consent form. The study was conducted between January 2015 to December 2018 with 50 patients of physical status I and II (ASA) of both sexes who underwent elective clavicle, shoulder and proximal humeral procedures in beach chairs associated with general anesthesia. The protocol was registered in the Brazil Platform (CAAE: 33373214.1.0000.5179). As part of Program ACERTO, all patients drank a single 200 mL liquid oral hypercaloric nutritional supplement (1.5 Kcal /mL) without residue, clarified and without addition of lipid and fiber (Fresubin Jucy®) about 2 to 4 hours before surgery. The sample size was based on the conservative calculation the population size of 95% and with a margin of error of 10%, obtaining the number of 50 patients, ages 18 to 60 years, weighing 60 to 80 kg, 160 to 180 cm tall. Exclusion criteria for posterior brachial plexus block were the presence of allergy to local anesthetics, bronchopulmonary disease, coagulopathy or neurological diseases with brachial plexus damage and emergency or classified surgery patients as class III or more of ASA physical state. All the blocks were performed using the landmarks as Figure 1.

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Section: Discussionsupporting

confidence: 87%

mentioning

confidence: 99%

Clinical efficacy of the brachial plexus via posterior approach for orthopedic surgery

Imbelloni¹,

Teixeira²,

Lima³

et al. 2020

JACCOA

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“…Recent studies have found that a sub-anesthetic dose of ketamine can significantly reduce the psychiatric symptoms induced by ketamine. The sub-anesthetic dose of ketamine is defined as intravenous ketamine ≤ 0.5 mg kg −1 , usually 0.1–0.5 mg kg −1 ( Imbellon et al, 2017 ). Studies have also shown that 0.3 mg kg −1 ketamine used in painless induced abortion anesthesia did not cause delirium, sleep talk, and other mental symptoms ( Schwenk et al, 2018 ), so we selected three different doses of ketamine in this study for clinical observation, in order to optimize the lowest effective treatment dose.…”

Section: Discussionmentioning

confidence: 99%

Effects of a Single Sub-Anesthetic Dose of Ketamine on Postoperative Emotional Responses and Inflammatory Factors in Colorectal Cancer Patients

et al. 2022

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Objective: To investigate the effect of a single sub-anesthetic dose of ketamine on postoperative anxiety, depression, and inflammatory factors in patients with colorectal cancer.Methods: A total of 104 patients undergoing selective colorectal surgery in our hospital from Jan 2015 to Oct 2017 were included and randomly assigned (1:1:1:1) into a 0.1 mg kg−1 ketamine group (K1 group), 0.2 mg kg−1 ketamine group (K2 group), 0.3 mg kg−1 ketamine group (K3 group), or control group (C group). Corresponding doses of ketamine were given intravenously in the K groups (K1, K2, and K3 groups) 5 min before operation, and the same amount of normal saline was given in the C group. The intravenous analgesia program was identical in the four groups. The patients’ emotional reactions (anxiety and depression) were assessed by the Hospital Anxiety and Depression Scale (HAD), the quality of postoperative recovery was evaluated by the Quality of Recovery-40 (QoR-40) questionnaire, and the levels of IL-6, IL-8, and TNF-α in peripheral blood were detected by enzyme-linked immunosorbent assay (ELISA) on the day before operation and within 24, 48, and 72 h post-operation respectively. Pain was estimated by the visual analog scale (VAS), and sedation was assessed with Ramsay score 30 min after extubation. The time points of anesthetic end and extubation were recorded. The complications during anesthesia and recovery such as cough and agitation 30 min after extubation were recorded.Results: The anxiety score (HAD-A) and depression score (HAD-D) of the K3 group were significantly lower than those of the C group post-operation (p < 0.05). The QoR-40 score of the K3 group was significantly higher than that of the C group (p < 0.05). The serum levels of IL-6, IL-8, and TNF-α in the K3 group were significantly lower than those in the C group (p < 0.05 and p < 0.01). There were no significant differences in HAD-A, HAD-D, and QoR-40 scores or serum levels of IL-6, IL-8, and TNF-α between the K1 and K2 groups and the C group. There were no significant differences in VAS pain score or Ramsay sedation score among the four groups 30 min after extubation. There were no significant differences in extubation time, postoperative cough, emergence agitation, or delirium among the four groups. Dizziness, nausea, vomiting, diplopia, or other adverse reactions were not found 30 min after extubation.Conclusion: A single sub-anesthetic dose (0.3 mg kg−1) of ketamine can significantly improve the postoperative anxiety and depression of colorectal cancer patients and reduce the levels of IL-6, IL-8, and TNF-α.

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“… 15 Esketamine is twice as potent as racemic ketamine. Similarly, to the study by Imbellon et al, 16 we used a single IV injection of 0.25 mg/kg of esketamine as a subanesthetic dose.…”

Section: Discussionmentioning

confidence: 99%

Effect of single intravenous injection of esketamine on quality of recovery during early period after modified radical mastectomy for breast cancer: A retrospective study

Fei,

Yan,

Yao

2023

Pak J Med Sci

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Objective: To assess the impact of a single esketamine intravenous (IV) injection on the quality of recovery during early period after modified radical mastectomy for breast cancer. Methods: This retrospective study included 80 patients who underwent modified radical mastectomy under general anesthesia in Huzhou Maternity & Child Health Care Hospital from March to October 2022. All patients were between 35 to 55 years, weighting between 45 and 70 kg and Grade-I or II according to the American Society of Anesthesiologists (ASA). Patients were grouped based on the type of pain management used. Patients (n=40) who were given 0.25 mg/kg esketamine single IV injection prior to completion of the surgery were assigned to Group-E, and patients (n=40) who were not treated with esketamine, comprised the control Group-C. Patients’ data, such as education years, operation time, blood loss, the 9-item Quality of Recovery (QoR-9) scores before the anesthesia induction (T0), one (T1) and two hours after the extubation (T2), the 40-item Quality of Recovery (QoR-40) scores one (D1) and two days after the surgery (D2), and the rate of adverse reactions were assessed in both groups. Results: Compared with T0, the QoR-9 scores at T1 and T2 were markedly lower in all patients. Compared to Group-C, the QoR-9 scores at T1 and T2 in Group-E were considerably increased (P<0.05). Similarly, the QoR-40 scores on D1 and D2 in Group-E were significantly higher compared to Group-C (P<O.05). Conclusion: Single intravenous injection of esketamine can improve the quality of the recovery of breast cancer patients during the early period after the modified radical mastectomy. doi: https://doi.org/10.12669/pjms.39.6.8057 How to cite this: Fei G, Yan W, Yao H. Effect of single intravenous injection of esketamine on quality of recovery during early period after modified radical mastectomy for breast cancer: a retrospective study. Pak J Med Sci. 2023;39(6):---------. doi: https://doi.org/10.12669/pjms.39.6.8057 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Comparison of the effects of four subdoses of dextroketamine to reduce pain during posterior brachial plexus block: A randomized double blind study

Cited by 5 publications

References 17 publications

Clinical efficacy of the brachial plexus via posterior approach for orthopedic surgery

Clinical efficacy of the brachial plexus via posterior approach for orthopedic surgery

Effects of a Single Sub-Anesthetic Dose of Ketamine on Postoperative Emotional Responses and Inflammatory Factors in Colorectal Cancer Patients

Effect of single intravenous injection of esketamine on quality of recovery during early period after modified radical mastectomy for breast cancer: A retrospective study

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