Effects of subanesthetic doses of ketamine on hemodynamic and immunologic variables in dogs with experimentally induced endotoxemia

DeClue, Amy E.; Cohn, Leah A.; Lechner, Elizabeth S; Bryan, Margarette; Dodam, John R.

doi:10.2460/ajvr.69.2.228

Cited by 57 publications

(37 citation statements)

References 26 publications

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“…Results regarding the effect of a subanesthetic dose of ketamine on hemodynamic stability have been conflicting [23,24]. The low dose of ketamine administered in this study was not able to prevent the bradycardia caused by high doses of remifentanil.…”

Section: Discussionmentioning

confidence: 62%

Interaction between postoperative shivering and hyperalgesia caused by high-dose remifentanil

Song

Lee

Seo

et al. 2014

Korean J Anesthesiol

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BackgroundHigh-dose remifentanil-based anesthesia is associated with opioid-induced hyperalgesia (OIH) and postanesthetic shivering (PAS). These effects can be prevented by N-methyl-d-aspartate (NMDA) receptor antagonists. This study aimed to investigate correlations between OIH and PAS caused by high-dose remifentanil and the effects of low-dose ketamine on OIH and PAS.MethodsSeventy-five patients scheduled for single-port laparoscopic gynecologic surgery were randomly allocated into three groups, each of which received intraoperative remifentanil: group L at 0.1 µg/kg/min; group H at 0.3 µg/kg/min; and group HK at 0.3 µg/kg/min plus 0.25 mg/kg ketamine just before incision, followed by a continuous infusion of 5 µg/kg/min ketamine until skin closure.ResultsPAS, postoperative tactile pain threshold, and the extent of hyperalgesia in group H were significantly different (P < 0.05) than in the other two groups. PAS was significantly correlated with OIH, including mechanically evoked pain such as postoperative tactile pain threshold (r = -0.529, P = 0.01) (r = -0.458, P = 0.021) and the extent of hyperalgesia (r = 0.537, P = 0.002) (r = 0.384, P = 0.031), respectively, in group H and group HK. Notably, both groups were treated with high-dose remifentanil. Tympanic membrane temperature, time to first postoperative analgesic requirement, postoperative pain scores, analgesic consumption, and cumulative patient-controlled analgesia volume containing morphine were comparable in all three groups.ConclusionsOIH, including the enhanced perception of pain, and PAS were both associated with high-dose remifentanil, were significantly correlated and were attenuated by a low dose of ketamine. This suggests that a common mechanism in part mediated through activation of the central glutamatergic system (e.g., NMDA receptors), underlies the two effects caused by high doses of remifentanil.

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Section: Discussionmentioning

confidence: 62%

Interaction between postoperative shivering and hyperalgesia caused by high-dose remifentanil

Song

Lee

Seo

et al. 2014

Korean J Anesthesiol

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“…Additionally, when given either before or after various pro-inflammatory insults, ketamine has been shown to diminish systemic production of cytokines, such as interleukins -1α, -1β, and -6 (IL-1α, IL-1β, and IL-6), tumor necrosis factor-α (TNF-α), and interferon-γ (IFN-γ), and improve survival (3, 5, 9). Furthermore, recent evidence suggests that ketamine improves end-organ dysfunction and has anti-inflammatory effects that appear to be present even at sub-anesthetic (sedative) doses (10-12). …”

Section: Introductionmentioning

confidence: 99%

Effects of Ketamine on Endotoxin and Traumatic Brain Injury Induced Cytokine Production in the Rat

Ward

Harting

Cox

et al. 2011

Journal of Trauma: Injury, Infection &Amp; Critical Care

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Background Endotoxemia from lipopolysaccharide (LPS) induces systemic cytokine production, whereas traumatic brain injury (TBI) increases intracerebral cytokine production. In anesthetic doses, ketamine has potent anti-inflammatory properties. However, its anti-inflammatory effects at sub-anesthetic doses and its effects upon TBI induced inflammation have not been fully investigated. We hypothesized that ketamine would attenuate both LPS and TBI induced inflammatory responses. Methods Male rats received intraperitoneal ketamine (70, 7, or 1 mg/kg IP) or saline one hour before LPS (20 mg/kg IP) or saline. Five hours after LPS, rats were sacrificed. Serum was collected for cytokine analysis. In other experiments, male rats were given ketamine (7 mg/kg IP) or saline one hour prior to induction of TBI with controlled cortical impact (or sham). One and six hours following injury, brain was extracted for analysis of cerebral edema and cytokine production. Results LPS increased the serum concentrations of IL-1α, IL-1β, IL-6, IL-10, TNF-α, and IFN-γ. Ketamine dose dependently attenuated these changes. TBI caused cerebral edema and increased concentrations of cerebral IL-1α, IL-1β, IL-6, IL-10, and TNF-α. However, ketamine had minimal effect on TBI induced inflammation. Conclusions While ketamine did not appear to exert any beneficial effects against TBI in the rat, it did not exacerbate cytokine production or enhance cerebral edema as some studies have suggested.

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“…Ketamine has anti-inflammatory actions at sedative (subanesthetic) doses 116. Furthermore, it affects the immunoregulatory activities of macrophages, neutrophils, mast cells, and white blood cells 117–121.…”

Section: Perioperative Analgesicsmentioning

confidence: 99%

Impact of perioperative pain management on cancer recurrence: an ASRA/ESRA special article

Missair

Cata

Votta-Velis

et al. 2019

Regional Anesthesia &Amp; Pain Medicine

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Cancer causes considerable suffering and 80% of advanced cancer patients experience moderate to severe pain. Surgical tumor excision remains a cornerstone of primary cancer treatment, but is also recognized as one of the greatest risk factors for metastatic spread. The perioperative period, characterized by the surgical stress response, pharmacologic-induced angiogenesis, and immunomodulation results in a physiologic environment that supports tumor spread and distant reimplantation.In the perioperative period, anesthesiologists may have a brief and uniquewindow of opportunity to modulate the unwanted consequences of the stressresponse on the immune system and minimize residual disease. This reviewdiscusses the current research on analgesic therapies and their impact ondisease progression, followed by an evidence-based evaluation of perioperativepain interventions and medications.

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Effects of subanesthetic doses of ketamine on hemodynamic and immunologic variables in dogs with experimentally induced endotoxemia

Abstract: Administration of a subanesthetic dose of ketamine had immunomodulating effects in dogs with experimentally induced endotoxemia (namely, blunting of plasma TNF-alpha activity). However, it had little effect on hemodynamic stability and no effect on WBC counts.

Cited by 57 publications

References 26 publications

Interaction between postoperative shivering and hyperalgesia caused by high-dose remifentanil

Interaction between postoperative shivering and hyperalgesia caused by high-dose remifentanil

Effects of Ketamine on Endotoxin and Traumatic Brain Injury Induced Cytokine Production in the Rat

Impact of perioperative pain management on cancer recurrence: an ASRA/ESRA special article

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