Effects of Ketamine on the Pregnant Uterus

Oats, Jeremy N.; Vasey, D. P.; Waldron, B. A.

doi:10.1093/bja/51.12.1163

Cited by 81 publications

(11 citation statements)

References 5 publications

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“…Ketamine: Ketamine rapidly crosses the placenta; however, no foetal effects have been observed during organogenesis and near delivery in rats, mice, rabbits and dogs . Ketamine increases uterine tone and should be avoided during pregnancy . An in‐depth review of caesarean section in dogs is available…”

Section: Section 3: Pain Management Protocolsmentioning

confidence: 99%

Guidelines for Recognition, Assessment and Treatment of Pain

Mathews¹,

Kronen²,

Lascelles³

et al. 2014

J of Small Animal Practice

267

122

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Section: Section 3: Pain Management Protocolsmentioning

confidence: 99%

Guidelines for Recognition, Assessment and Treatment of Pain

Mathews¹,

Kronen²,

Lascelles³

et al. 2014

J of Small Animal Practice

267

122

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Section: Eceiijed 12 March Accepted For Publication 26 4pril 1982mentioning

confidence: 86%

“…Results consistent with those of Galloon were obtained by MARX et al (1979), whostudied the effect of increasing doses of ketamine on uterine activity in the immediate puerperium. However, OATS et al (1979) found no increase in uterine contraction in late pregnancy.There are no studies on uterine motility in gynecologic patients anesthetized with ketamine. This investigation was carried out to evaluate the influence of ketamine on uterine activity in the non-pregnant state with tlicaid o f intrauterine pressure recordings by microtip trarisducers.…”

mentioning

confidence: 86%

Influence of Ketamine on Non‐Pregnant Uterus in Vivo

Idvall

Sandahl

Stenberg

et al. 1982

Acta Anaesthesiol Scand

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This investigation was performed to evaluate the effect of ketamine anesthesia on non-pregnant uterine activity. Seven healthy non-pregnant women took part in the study. Anesthesia was induced with an i.v. bolus injection of ketamine 2 mg/kg and maintained with a continuous i.v. ketamine infusion, mean dosage 39 micrograms/kg/min. Before induction of anesthesia, each patient was placed in the lithotomy position, and a catheter fitted with two microtransducers for monitoring of intra-uterine pressures was fed through the cervix into the uterine cavity. For determination of plasma concentrations of ketamine and norketamine, venous blood samples were collected. The assay was based on a gas-liquid chromatographic technique. It was found that ketamine induced an increased uterine activity, both in basal tone and intensity of contractions. Only minor effects on the frequency were observed. This stimulatory effect was simultaneous with a hemodynamic stimulation with increases in heart rate and arterial blood pressure, and with the peak plasma concentration of ketamine.

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“…Der Augeninnendruck wird unwesentlich erhöht [67]. Es fanden sich Hinweise für eine gesteigerte Gesamtmotilität des Uterus bei Patientinnen mit Dystokie [35] ebenso wie gegenteilige Befunde bei elektiver Sectio [134]; eine klinische Relevanz wurde insgesamt verneint [120]. Es fanden sich Hinweise für eine gesteigerte Gesamtmotilität des Uterus bei Patientinnen mit Dystokie [35] ebenso wie gegenteilige Befunde bei elektiver Sectio [134]; eine klinische Relevanz wurde insgesamt verneint [120].…”

Section: Leitthemaunclassified

Vom Razemat zum Eutomer: (S)-Ketamin

Adams

Werner

1997

Der Anaesthesist

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The pharmacological profile of ketamine: Until recently, clinically available ketamine was a racemic mixture containing equal amounts of two enantiomers, (S)- and (R)-ketamine. The pharmacological profile of racemic ketamine is characterized by the so called dissociative anesthetic state and profound sympathomimetic properties. Among the different sites of action, N-methyl-D-aspartate (NMDA)-receptor antagonism is considered to be the most important neuropharmacological mechanism of ketamine. Effects on opiate receptors, monoaminergic and cholinergic transmitters, and local anesthetic effects are obvious as well. Following intravenous administration, a rapid onset of action is seen within 1 min, lasting for about 10 min. The anaesthetic state is terminated due to redistribution, followed by hepatic and renal elimination with a half-life period of 2-3 h. For alternative administration, the intramuscular and oral route is also appropriate. The most important adverse effects are hallucinations and excessive increases in blood pressure and heart rate. These reactions can be attenuated or avoided by combining of ketamine with sedative or hypnotic drugs like midazolam and/or propofol. During controlled ventilation, increases in intracranial pressure are unlikely to occur. The special pharmacological profile of (S)-ketamine: In general, the pharmacological properties of (S)-ketamine are comparable to the racemic compound. On the different sites of action, qualitatively comparable effects were found, but significant quantitative differences also became obvious. When compared with (R)-ketamine and the racmic mixture, the analgesic and anesthetic potency of (S)-ketamine is threefold or twofold higher. Thus, a 50% reduction of dosage is possible to achieve comparable clinical results. Because of the faster elimination of (S)-ketamine, better control of anesthesia will be provided. In summary, the pharmacokinetic improvements of (S)-ketamine are characterized by a reduced drug load, along with more rapid recovery. The clinical use of (S)-ketamine: The clinical use of (S)-ketamine depends on its analgesic and sympathomimetic properties, whereas the anaesthetic potency remains in the background. In clinical anesthesiology, (S)-ketamine, especially in combination with midazolam and/or propofol, can be used for short procedures with preserved spontaneous ventilation, for induction of anesthesia in patients with shock or asthmatic disorders, and for induction and maintenance of anesthesia in caesarean sections. Additional indications are repeated anesthesia, for example, in burn patients, analgesia during delivery and diagnostic procedures and intramuscular administration in uncooperative patients. The value of (S)-ketamine as an analgesic component for total intravenous anesthesia has not been defined yet. In comparison with opioides, the advantages are related to improved hemodynamic stability and reduced postoperative respiratory depression. When (S)-ketamine, especially in combination with midazolam, is used for analgosedatio...

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Effects of Ketamine on the Pregnant Uterus

Cited by 81 publications

References 5 publications

Guidelines for Recognition, Assessment and Treatment of Pain

Guidelines for Recognition, Assessment and Treatment of Pain

Influence of Ketamine on Non‐Pregnant Uterus in Vivo

Vom Razemat zum Eutomer: (S)-Ketamin

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