Evaluation of the effects of ketamine on spinal anesthesia with levobupivacaine or ropivacaine

Zhang, Yan; Lin, Hong; Wen-bo, YI

doi:10.3892/etm.2016.3587

Cited by 6 publications

(4 citation statements)

References 61 publications

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“…This method requires catheterization of the subarachnoid space. The catheter insertion could be performed through the atlanto-occipital membrane [ 56 ] or at the junction of the L5 and L6 lumbar vertebrae [ 57 ] under general inhalation [ 58 ] or injection anesthesia [ 59 ].…”

Section: Resultsmentioning

confidence: 99%

Anesthetic protocols for urodynamic studies of the lower urinary tract in small rodents—A systematic review

et al. 2021

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Urodynamic studies in rats and mice are broadly used to examine pathomechnisms of disease and identify and test therapeutic targets. This review aims to highlight the effects of the anesthetics on the lower urinary tract function and seeks to identify protocols that allow recovery from anesthesia and repeated measurements while preserving the function which is being studied. All studies published in English language, which compared the data obtained under various types of anesthesia and the urodynamics performed in awake animals were included. It appears that urethane, an anesthetic recommended extensively for the investigation of lower urinary tract function, is appropriate for acute urodynamic studies only. Major advantages of urethane are its stability and ability to preserve the micturition reflex. Due to its toxicity and carcinogenicity, urethane anesthesia should not be used for recovery procedures. This review evaluated available alternatives including propofol, isoflurane and combinations of urethane, ketamine/xylazine, ketamine/medetomidine, and/or fentanyl/fluanisone/midazolam. Different effects have been demonstrated among these drugs on the urinary bladder, the urethral sphincter, as well as on their neuroregulation. The lowest incidence of adverse effects was observed with the use of a combination of ketamine and xylazine. Although the variations in the reviewed study protocols represent a limitation, we believe that this summary will help in standardizing and optimizing future experiments.

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Section: Resultsmentioning

confidence: 99%

Anesthetic protocols for urodynamic studies of the lower urinary tract in small rodents—A systematic review

et al. 2021

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“…Ketamine is an N-methyl-D-aspartate (NMDA) antagonist and has strong analgesic effects ( 6 ), which can be attributed to its effect on a number of opioid, muscarinic, and NMDA receptors ( 7 ). Administering ketamine with ropivacaine or levobupivacaine increases the intensity and duration of spinal anesthesia ( 6 ). Dexmedetomidine is an alpha-2 receptor agonist whose analgesic effect seems to be related to the release of acetylcholine.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Dexmedetomidine and Ketamine in Serratus Anterior Plane Block for Postoperative Pain Control in Thoracotomy Patients: A Randomized Clinical Trial

Rashidi,

Mahmoodi,

Akhondzadeh

et al. 2024

Anesth Pain Med

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Background: Postoperative pain control after thoracotomy is very important, and if not controlled, it can cause severe complications. Objectives: This study aimed to compare dexmedetomidine and ketamine in serratus anterior plane block (SAPB) in pain control after thoracotomy. Methods: This randomized clinical trial was conducted on 74 patients aged 18 to 60 years old with American Society of Anesthesiologists (ASA) class I or II who were referred to Imam Khomeini hospital in Ahvaz, Iran, for thoracotomy and randomly divided into two groups. After surgery, the SAPB with ultrasound-guided was performed. In the ropivacaine-ketamine (RK) group, ketamine 0.5 mg/kg and 0.4 cc/kg ropivacaine solution 0.25% and in the ropivacaine-dexmedetomidine (RD) group, in addition to 0.4 cc/kg ropivacaine 0.25%, dexmedetomidine 0.5 µg/kg was added. Verbal Numeric Scale (VNS), systolic blood pressure (SBP), diastolic blood pressure (DBP), respiratory rate (RR), heart rate (HR), and mean arterial blood pressure (MAP) were recorded. Results: There was no significant difference in both groups in terms of demographic information (P < 0.05). The average VNS was lower in the ketamine group than in the dexmedetomidine group; however, there was a significant difference only at 1, 12, and 24 hours after surgery (P < 0.05). There was no statistically significant difference between the two groups in terms of SBP and DBP, HR, and MAP. There was a significant difference in the RR in the two groups at 12 and 24 hours after the operation (P < 0.05). Conclusions: Dexmedetomidine and ketamine, which were used as supplements to ropivacaine for SAPB in patients undergoing elective thoracotomy, reduced the pain intensity after thoracotomy; nevertheless, the intensity of pain reduction was more and more effective in the group receiving ketamine.

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“…It is reported to be the most myotoxic local anesthetic available and is associated with notable cardiotoxic and neurotoxic effects. [5][6][7] Existing medical literature has explored intravenous lipid emulsions and cerebrospinal fluid (CSF) exchange as potential strategies to counteract the undesirable effects of a high or total spinal block. Although the symptoms of sympathectomy manifest rapidly, current treatment approaches tend to be limited in their application and often exhibit a delayed onset of action.…”

Section: Introductionmentioning

confidence: 99%

Rat Model: Intrathecal Lipid for Total Spinal BlockInduced Hemodynamic Instability

Darçın

2023

J Clin Pract Res

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Objective: This study aimed to assess the potential of intrathecal administration of lipid emulsions as a targeted therapeutic strategy to mitigate the hemodynamic consequences of high or total spinal anesthesia induced by bupivacaine in a rat model. Materials and Methods: After receiving approval from Koç University's Local Ethics Board of Animal Experiments, 14 adult female Wistar Albino rats were randomized into two groups: Lipid and Saline. After inducing a high spinal block, each group was treated with either intrathecal lipid emulsions or isotonic saline solutions, respectively. Hemodynamic parameters such as systolic, diastolic, and mean arterial blood pressures, as well as heart rate, were continuously monitored. A histological analysis was conducted upon completion of the study. Results:The Lipid group exhibited a significant increase in mean systolic (p=0.002), diastolic (p=0.002), and arterial pressures (p=0.002) compared to the Saline group. The mean pulse rate also differed significantly between the groups (p=0.009). Notably, while all rats in the Saline group succumbed, only two fatalities occurred in the Lipid group, with the other five rats surviving (p=0.021). Conclusion:This study suggests that intrathecal administration of lipid emulsions can serve as a rapid and effective intervention to counteract the hypotension and bradycardia induced by high or total spinal anesthesia with bupivacaine in rats. While these findings are promising, further experimentation and clinical trials are required to confirm this method's potential, focusing on its long-term safety, efficacy, and the establishment of an optimal administration protoco.

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Evaluation of the effects of ketamine on spinal anesthesia with levobupivacaine or ropivacaine

Cited by 6 publications

References 61 publications

Anesthetic protocols for urodynamic studies of the lower urinary tract in small rodents—A systematic review

Anesthetic protocols for urodynamic studies of the lower urinary tract in small rodents—A systematic review

Comparison of Dexmedetomidine and Ketamine in Serratus Anterior Plane Block for Postoperative Pain Control in Thoracotomy Patients: A Randomized Clinical Trial

Rat Model: Intrathecal Lipid for Total Spinal BlockInduced Hemodynamic Instability

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