Ketamine for Perioperative Pain Management

Himmelseher, Sabine; Durieux, Marcel E.

doi:10.1097/00000542-200501000-00030

Cited by 385 publications

(219 citation statements)

References 53 publications

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“…This result was comparable with other studies [15,16] which showed that small doses of ketamine reduced opioid requirements for postoperative pain. Although this effect of ketamine may be due to antagonism of spinal NMDA receptor sites, it can act on several receptor systems such as opioidergic and cholinergic [17].…”

Section: Discussionsupporting

confidence: 91%

Pre-Incisional Intravenous Low-Dose Ketamine Does Not Cause Pre- Emptive Analgesic Effect Following Caesarean Section under Spinal Anaesthesia

Ej¹,

Cn²,

Fyneface-Ogan³

2011

J Anesthe Clinic Res

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Background: Adequate postoperative pain relief is one of the commonest challenges faced by women who deliver by caesarean section.Aim: This study was aimed at finding out the effect of pre-incisional administration of low dose intravenous ketamine on the post-operative analgesia demand time. Patients and Methods:Following approval from the Hospital's Ethical Committee, a prospective, randomised double-blind study was carried out to evaluate the pre-emptive effect of low-dose ketamine on women undergoing elective caesarean section under plain bupivacaine/fentanyl spinal anaesthesia.Results: Eighty women completed (83.33%) the study. The results were comparable in both groups for maternal age, weight, height, gestational age and parity. There was no statistical difference in the patient characteristics between the two groups under study.The mean time taken to achieve a maximal sensory level was 9.3±0.91 mins in Group-A and in Group-B 8.35±1.49 mins, p=0.260. The regression time to two segments was also the same in the two groups of women. The mean in the Group-A was 28.1±1.52 mins while the Group-B had 27.6±2.10 mins, p=0.161.The time to first analgesic request in the Ketamine Group was 193.44±26.53 mins while that for the Placebo group was 140.14±22.34 mins. The difference in the duration was statistically significant, p=0.0001. Conclusion:It is concluded that the pre-incisional administration of low-dose intravenous ketamine only demonstrated a delayed time to first analgesic request in the women who had plain bupivacaine/fentanyl spinal anaesthesia and not a pre-emptive analgesic effect.

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Section: Discussionsupporting

confidence: 91%

Pre-Incisional Intravenous Low-Dose Ketamine Does Not Cause Pre- Emptive Analgesic Effect Following Caesarean Section under Spinal Anaesthesia

Ej¹,

Cn²,

Fyneface-Ogan³

2011

J Anesthe Clinic Res

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“…Кетамин демонстрирует анальгетическую актив-ность даже при использовании субнаркотических доз за счет антагонизма к NMDA-рецепторам [6]. При этом кетамин модулирует центральную сен-сорную обработку боли.…”

Section: Scientific Review научный обзорunclassified

“…В исследованиях на живот-ных и человеке было показано, что кетамин являет-ся мощным антигиперальгическим средством. Он предотвращает развитие опиоидиндуцированной гиперальгезии и толерантности к опиоидам [6].…”

Section: Scientific Review научный обзорunclassified

“…Авторы утверждают, поскольку действие кетамина обусловлено блокированием центральной сенситизации, в плазме и тканях цен-тральной нервной системы его уровень должен со-храняться на протяжении всего периода болевой стимуляции, который включает в себя не только операцию, но также и послеоперационный период [6]. Однако, несмотря на теоретическую привлека-тельность этого подхода, в литературе нет достаточ-ного количества данных, чтобы поддержать его пре-восходство.…”

Section: стратегии применения кетаминаunclassified

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Роль Кетаміну У Періопераційному Знеболюванні (Огляд)

Klygunenko¹,

Khalimonchyk²

2022

ЕМ

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“…Also consider a ketamine infusion if pain proves refractory to other measures in the postoperative period. 63 Anesthetic technique Strongly consider use of regional anesthesia.…”

Section: Multimodal Analgesic Strategiesmentioning

confidence: 99%

Brief review: Perioperative management of the patient with chronic non-cancer pain

Ibrahim

Morley‐Forster

Dain

et al. 2006

Can J Anesth/J Can Anesth

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Purpose: Both opioid and non-opioid medications are being utilized increasingly in the treatment of chronic non-cancer pain, and the number of surgical patients receiving large regular doses of opioids is ever-expanding. The perioperative pain control of these patients is often challenging, and is broadening the role of the anesthesiologist as 'perioperative physician'. These patients need to be identified before surgery to plan optimal pain control postoperatively. The purpose of this review is to provide an update on the important considerations in managing the chronic non-cancer pain patient receiving high dose opioids and other adjunctive medications/analgesics. Source: English language articles published between June 1980 and May 2006 were identified by a computerized Medline search using keywords ˝chronic pain˝, ˝opioid dependent˝ and ˝perioperative˝. This same search strategy was repeated and updated using both Medline and Embase. All relevant publications were retrieved and their bibliographies were scanned for additional sources. Principal findings:Although an increasingly common problem for the acute pain service, there is very little published on this topic. Key points include the concept of opioid equivalency, tolerance, the role of adjunctive medications, and the need for good communication between the surgical team, the acute pain service and the patient who is often anxious about the upcoming procedure due to previous unpleasant experiences with poor pain control in hospital. Conclusion:Clinical care of the opioid-dependent patient in the perioperative period can be a daunting task. Education to all staff involved in this area needs to be enhanced to improve outcome and patient satisfaction. Objectif

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Ketamine for Perioperative Pain Management

Cited by 385 publications

References 53 publications

Pre-Incisional Intravenous Low-Dose Ketamine Does Not Cause Pre- Emptive Analgesic Effect Following Caesarean Section under Spinal Anaesthesia

Pre-Incisional Intravenous Low-Dose Ketamine Does Not Cause Pre- Emptive Analgesic Effect Following Caesarean Section under Spinal Anaesthesia

Роль Кетаміну У Періопераційному Знеболюванні (Огляд)

Brief review: Perioperative management of the patient with chronic non-cancer pain

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