Intrathecal Ketamine with Preservative-Histological Effects on Spinal Nerve Roots of Baboons

Brock‐Utne, John G.; Kallichurum, S; Mankowitz, E; Maharaj, Ravi; Downing, J. W.

doi:10.1097/00132586-198308000-00048

Cited by 11 publications

(15 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The demonstration of the safety of intrathecal ketamine with preservatives in baboons by BrockUtne et al 8 led Makowitz et al 9 to administer ketamine with preservative into the extradural space to humans suffering from chronic pain, in an uncontrolled study. This paper reports a prospective randomized study with two different doses of epidural ketamine to determine the analgesic and side effects of this technique while employing intramuscular (IM) ketamine as a control, in patients undergoing gallbladder surgery.…”

Section: Epidural Ketamine For Postoperative Analgesiamentioning

confidence: 99%

Epidural ketamine for postoperative analgesia

Naguib¹,

Adu-Gyamfi²,

Absood³

et al. 1986

Can Anaesth Soc J

View full text Add to dashboard Cite

Section: Epidural Ketamine For Postoperative Analgesiamentioning

confidence: 99%

Epidural ketamine for postoperative analgesia

Naguib¹,

Adu-Gyamfi²,

Absood³

et al. 1986

Can Anaesth Soc J

View full text Add to dashboard Cite

“…A Ac ck kn no ow wl le ed dg ge em me en nt t The grading of the immunocytochemical examination was as follows: 0= none; 1= rare (2-3), 2= few (3-10), 3= moderate (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) and 4= serious (> 20 neurons).…”

Section: Resultsmentioning

confidence: 99%

“…10,11 In later studies, it was declared that the preservative substances in the ketamine preparations, especially chlorobutanol, were responsible for the histopathologic changes, and that these neurotoxic changes were not seen when ketamine was used with the preservative benzethonium chloride or without preservatives. 9,12 In recent years, however, there have been some reports indicating that histopathological changes were observed when preservative-free ketamine was applied intrathecally.…”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7][8] Although a variety of anesthetic medicines are used intrathecally on a daily basis, experimental neurotoxic studies on these drugs are not sufficient, and contradictory results have been reported. [9][10][11][12] In order to increase the safety of clinical practices, there is a need for more experimental studies evaluating the neurotoxic effects of anesthetics, without the need for clinical feedback.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Neurotoxic Effects of Ketamine and Different Doses of Ropivacaine Administered Intrathecally in Rabbits

Sezen¹,

Demiraran²,

Güven³

et al. 2013

Turkiye Klinikleri J Med Sci

View full text Add to dashboard Cite

A AB BS S T TR RA AC CT T O Ob b j je ec c t ti i v ve e: : Although a variety of anesthetic medicines are used intrathecally, experimental neurotoxic studies on these drugs are not sufficient. In our study, we used immunocytochemical examination to assess the neurotoxic potential of ketamine and different doses of ropivacaine administered intrathecally. M Ma a t te e r ri i a al l a an nd d M Me et t h ho od ds s: : Thirty rabbits were divided into five groups which were inserted spinal catheters under anesthesia. Each group received in a volume of 0.3 ml, as follows: the R0.2 group received 0.2% ropivacaine, the R0.75 group received 0.75% ropivacaine, the R1 group received 1.0% ropivacaine, the K group received preservative-free S (+) ketamine and the C group received 0.9% NaCl. The onset and duration of action were recorded by using Motor Dysfunction Index (MDI). Rabbits were observed for five days and then euthanasized. After catheters were removed, brains and spinal tissue samples were evaluated by light microscopy and immunocytochemical examination. R Re e s su ul lt ts s: : The longest onset of action was observed in the K group. Among the ropivacaine groups, the onset of action diminished and the duration of action extended with an increase in dose significantly. There was axonal degeneration in the R1 group, but this finding not reach significance. In the ketamine group, significant neuronal degeneration and reduction in number of neurons in the brain sections were observed . In the 1% ropivacaine group, a relative increase in neurofilament intensity was detected using immunocytochemical assessments in the medulla spinalis and brain sections. C Co on nc c l lu u s si i o on n: : The intrathecal applications of 1% ropivacaine and ketamine can induce neurotoxic damage, despite a lack of observed functional neurologic deficits.K Ke ey y W Wo or rd ds s: : Ro pi va ca i ne; ke ta mi ne; in jec ti ons, spi nal Ö ÖZ ZE ET T A Am ma aç ç: : İntratekal olarak uygulanan anestezik ilaçların çeşitliliğine karşın, bu ilaçların deneysel nörotoksik çalışmaları yeterli değildir. Çalışmamızda, intratekal olarak verilen ketamin ve farklı dozlardaki ropivakainin nörotoksik potansiyelini immunohistokimyasal olarak değerlendir-meyi amaçladık. G Ge e r re eç ç v ve e Y Yö ön n t te em m l le er r: : Anestetize edilerek spinal kateter yerleştirilmiş 30 tavşan 5 gruba ayrıldı. Grup R0.2'de ropivakain %0,2, grup R0.75'de ropivakain %0,75, grup R1'de ropivakain %1,0, grup K'de preservative-free S (+) ketamin ve grup C'de %0,9 NaCl 0,3 ml volümde spinal kateterden uygulandı. Etki başlangıç zamanı ve etki süreleri Motor Dysfunction Index (MDI) kullanılarak kaydedildi. Tavşanlar 5 gün gözlendikten sonra ötenazi uygulandı. Kateterler çıkar-ılarak beyin ve spinal doku örnekleri ışık mikroskopisi ve immunohistokimyasal metodla değer-lendirildi. B Bu ul l g gu u l la ar r: : En uzun etki başlangıcı grup K'de gözlemlendi. Ropivakain grupları içinde doz artışı ile birlikte etki başlangıç süreleri kısalarak, etki süreleri uzamış olarak t...

show abstract

“…Ketamine has well-known analgesic properties and animal experiments have shown that intrathecal administration of ketamine, with benzethonium chloride preservative, has no neurotoxic effects [4]. In some clinical studies, the extradural administration of ketamine has provided a potent and safe method for postoperative analgesia and has been proposed as an alternative to local anaesthetics and opioids [5, 61. This double-blind study was designed to compare the effects of extradural bupivacaine-adrenaline or bupivacaine-adrenaline-ketamine mixtures, on onset time of anaesthesia and the degree of sensory and motor block.…”

mentioning

confidence: 99%

The effect of extradural ketamine on onset time and sensory block in extradural anaesthesia with bupivacaine

Yanli

Eren

1996

Anaesthesia

View full text Add to dashboard Cite

SummaryIn a randomised, double blind study of 30patients, we have compared two regimens for extradural anaesthesia: 20 ml bupiuacaine 0.5%, 25mg (0.5ml) ketamine, I in 200000adrenaline; and20ml bupivacaine 0.5%, 0.5mlO.9% saline, 1 in 200000adrenaline.The main outcome measures were onset time to acceptable bilateral anaesthesia and postoperative analgesic duration. The time to onset of anaesthesia was reduced by 8 min in the bupivacaine-ketamine group compared with the bupivacaine alone group. In addition, the anaesthetic levels were two segments higher in the bupivacaine-ketamine group (TI oersus T9). Side effects were similar in both groups and there was no significant diflerence in postoperative analgesic requirements between the two groups. The addition of ketamine to bupivacaine given epidurally appears to be useful in the reduction of onset time to blockade. Key wordsAnaesthetic techniques; extradural. Analgesics; ketamine. Anaesthetics, local; bupivacaine.Extradural block provides satisfactory anaesthesia for many orthopaedic, gynaecological and urological procedures. However, the technique has a number of disadvantages [ 11; variation in the degree of sensory, motor and sympathetic nerve blockade may lead to painful intervals, variable muscle power and cardiovascular instability. In addition, extradural anaesthesia is associated with a slow onset time [2]. Adrenaline has been shown to improve the efficacy of extradural block [3], whilst the addition of opioids to local anaesthetics administered extradurally has been shown to improve analgesia, but not significantly to reduce the onset time [2].Ketamine has well-known analgesic properties and animal experiments have shown that intrathecal administration of ketamine, with benzethonium chloride preservative, has no neurotoxic effects [4]. In some clinical studies, the extradural administration of ketamine has provided a potent and safe method for postoperative analgesia and has been proposed as an alternative to local anaesthetics and opioids [5, 61. This double-blind study was designed to compare the effects of extradural bupivacaine-adrenaline or bupivacaine-adrenaline-ketamine mixtures, on onset time of anaesthesia and the degree of sensory and motor block. MethodsThe study was approved by the local ethics committee and written informed consent was obtained from all participants. Thirty patients, ASA 1 or 2 physical status, who were to undergo elective orthopedic, urological or lower abdominal surgery were recruited. Patients were not studied if they had a history of neurological, mental and spinal diseases or had a bleeding diathesis.No premedication was given. An intravenous infusion of compound sodium lactate solution 500 ml was started prior to extradural placement. Patients were randomly allocated to one of two groups. Neither the patient, nor the anaesthetist was aware of the group allocation. Two solutions were used for extradural anaesthesia: group 1 received 20 ml bupivacaine 0.5%, 1 in 200 000 adrenaline and 0.5 ml 0.9% saline; group 2 receiv...

show abstract

Intrathecal Ketamine with Preservative-Histological Effects on Spinal Nerve Roots of Baboons

Cited by 11 publications

References 0 publications

Epidural ketamine for postoperative analgesia

Epidural ketamine for postoperative analgesia

Neurotoxic Effects of Ketamine and Different Doses of Ropivacaine Administered Intrathecally in Rabbits

The effect of extradural ketamine on onset time and sensory block in extradural anaesthesia with bupivacaine

Contact Info

Product

Resources

About