Ketamine for pain management in France, an observational survey

Martinez, Valéria; Derivaux, Benoit; Beloeil, Hélène

doi:10.1016/j.accpm.2015.04.005

Cited by 18 publications

(6 citation statements)

References 24 publications

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“…46,47 Ketamine is also contraindicated in those patients who have underlying conditions such as aortic dissection, uncontrolled hypertension, myocardial infarction or aneurysms, in which increased blood pressure would pose a risk of complications. 48,49 Thus, concerns persist with regard to the safety and feasibility of prolonged use of ketamine. 44 The following limitations of the present study should be noted.…”

Section: Discussionmentioning

confidence: 99%

<p>BDNF and the Antidepressant Effects of Ketamine and Propofol in Electroconvulsive Therapy: A Preliminary Study</p>

Huang¹,

Xiong²,

He³

et al. 2020

NDT

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Objective: Ketamine and propofol have become increasingly popular in electroconvulsive therapy (ECT) anaesthesia. This study was conducted to examine whether changes in serum levels of brain-derived neurotrophic factor (BDNF) are associated with the antidepressant effects of ketofol, a combination of ketamine and propofol, in ECT for patients with treatment-resistant depression (TRD). Methods: Thirty patients with TRD (18-65 years) were enrolled and underwent eight ECT sessions with ketamine (0.5 mg/kg) plus propofol (0.5 mg/kg) (ketofol). Symptom severity was monitored using the 17-item Hamilton Depression Rating Scale (HAMD-17) and the Brief Psychiatric Rating Scale (BPRS), and serum levels of BDNF were examined by enzyme-linked immunosorbent assay (ELISA) at baseline and after 2, 4, and 8 ECT treatments. Serum levels of BDNF were also collected from thirty healthy controls. Results: At baseline, there were no significant differences in serum levels of BDNF between patients with TRD and healthy controls. The response and remission rates in patients with TRD were 100% (30/30) and 53.3% (16/30) after ECT treatment, respectively. Despite a significant reduction in HAMD-17 and BPRS scores after ECT, no changes in serum levels of BDNF were observed after ECT treatment when compared to baseline. No association was found between serum levels of BDNF and changes in illness severity. Conclusion: Serum levels of BDNF did not represent a suitable candidate biomarker for determining the antidepressant effects of ketofol during ECT for patients with TRD.

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Section: Discussionmentioning

confidence: 99%

<p>BDNF and the Antidepressant Effects of Ketamine and Propofol in Electroconvulsive Therapy: A Preliminary Study</p>

Huang¹,

Xiong²,

He³

et al. 2020

NDT

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“…Understanding the limitations of existing research, the general acceptance and widespread implementation of ketamine as an analgesic in the ED is surprising and may in part be due to emergency physicians’ familiarity with ketamine. Additionally, multiple free online access to medical education movement sites and blogs publicized ketamine as an alternative to opioids,and the American College of Emergency Physicians (ACEP) lists ketamine as an alternative to opioids thereby also increasing its credibility .…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review and Meta‐analysis of Ketamine as an Alternative to Opioids for Acute Pain in the Emergency Department

Karlow

Schlaepfer

Stoll

et al. 2018

Academic Emergency Medicine

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“…Therefore, researchers argue that those issues should tailor the interpretation of the findings26 and those negative results should not discard the potential role of ketamine in patients with cancer pain 25. After publication of those negative results, a survey of clinicians demonstrated that the practice of using ketamine was continued by 30% of the respondents24 and the use of ketamine to treat cancer pain and other types of pain by many specialists has continued 19,24. On balance, one must recognize that the existing data on the use of ketamine in children with cancer pain are very limited, most reports consist of small case series, and randomized clinical trials of ketamine to treat cancer pain in children are lacking.…”

Section: Discussionmentioning

confidence: 99%

Subanesthetic ketamine for pain management in hospitalized children, adolescents, and young adults: a single-center cohort study

Sheehy

Lippold

Rice

et al. 2017

JPR

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BackgroundSubanesthetic doses of ketamine, an N-methyl-d-aspartate receptor antagonist used as an adjuvant to opioid for the treatment of pain in adults with acute and chronic pain, have been shown, in some instances, to improve pain intensity and to decrease opioid intake. However, less is known about the role of ketamine in pain management in children, adolescents, and young adults.PurposeWe examined the effects of subanesthetic ketamine on pain intensity and opioid intake in children, adolescents, and young adults with acute and chronic pain syndromes treated in an inpatient setting.MethodsThis is a longitudinal cohort study of patients treated with subanesthetic ketamine infusions in regular patient care units in a tertiary pediatric hospital. Primary outcomes included changes in pain scores and morphine-equivalent intake.ResultsThe study cohort included 230 different patients who during 360 separate hospital admissions received subanesthetic ketamine infusions for pain management. Overall, ketamine infusions were associated with significant reductions in mean pain scores from baseline (mean pain scores 6.64 [95% CI: 6.38–6.90]) to those recorded on the day after discontinuation of ketamine (mean pain scores 4.38 [95% CI: 4.06–4.69]), p<0.001. Importantly, the effect of ketamine on pain scores varied according to clinical diagnosis (p=0.011), infusion duration (p=0.004), and pain location (p=0.004). Interestingly, greater reductions in pain scores were observed in patients with cancer pain and patients with pain associated with pancreatitis and Crohn’s disease. There were no records of psychotomimetic side effects requiring therapy.ConclusionThese data suggest that administration of subanesthetic ketamine for pain management is feasible and safe in regular inpatient care units and may benefit children, adolescents, and young adults with acute and chronic pain. This study is informative and can be helpful in determining sample and effect sizes when planning clinical trials to determine the role of subanesthetic ketamine infusions for pain management in pediatric patients.

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Ketamine for pain management in France, an observational survey

Abstract: Anaesthesiologists have integrated the benefit of ketamine in preventing hyperalgesia but there is no consensus on doses and duration. For other indications (acute and chronic pain treatment), toxicity and the absence of significant benefit call for guidelines from scientific societies.

Cited by 18 publications

References 24 publications

<p>BDNF and the Antidepressant Effects of Ketamine and Propofol in Electroconvulsive Therapy: A Preliminary Study</p>

<p>BDNF and the Antidepressant Effects of Ketamine and Propofol in Electroconvulsive Therapy: A Preliminary Study</p>

A Systematic Review and Meta‐analysis of Ketamine as an Alternative to Opioids for Acute Pain in the Emergency Department

Subanesthetic ketamine for pain management in hospitalized children, adolescents, and young adults: a single-center cohort study

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