Ketamine in adult cardiac surgery and the cardiac surgery Intensive Care Unit: An evidence-based clinical review

Mazzeffi, Michael; Johnson, Kyle M.; Paciullo, Christopher

doi:10.4103/0971-9784.154478

Cited by 44 publications

(21 citation statements)

References 46 publications

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“…[79][80][81] The use of ketamine in cardiac surgery was associated with decreased inflammation, opioid sparing, and improved patient satisfaction postoperatively. [82][83][84][85][86][87][88][89][90] Its use in the prevention of chronic poststernotomy pain has not been studied.…”

Section: Acetaminophenmentioning

confidence: 99%

Chronic Poststernotomy Pain

Kleiman

Sanders

Nemergut

et al. 2017

Regional Anesthesia and Pain Medicine

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Chronic pain following median sternotomy is common after cardiac surgery. If left untreated, chronic sternal pain can reduce quality of life, affecting sleep, mood, activity level, and overall satisfaction. This has a significant societal effect given the large number of cardiac surgeries annually. Although a number of pathophysiologic processes and risk factors are assumed to contribute, the exact cause and major risk factors remain unknown. Moreover, the treatment of chronic poststernotomy pain is often inadequate, relying on opioids and other medications that provide minimal benefit to the patient and have significant adverse effects. Indeed, little is known regarding the prevention of chronic pain development following sternotomy. This review aims to present the current, limited data regarding the incidence, risk factors, treatment, and prevention of chronic poststernotomy pain and to identify areas of future research to improve management of this common complaint following cardiac surgery.

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Section: Acetaminophenmentioning

confidence: 99%

Chronic Poststernotomy Pain

Kleiman

Sanders

Nemergut

et al. 2017

Regional Anesthesia and Pain Medicine

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“…[ 7 8 9 ] In cardiac surgery and the cardiac Intensive Care Unit (ICU), only one review has focused specifically on ketamine, without truly addressing its use for pain management. [ 10 ]…”

Section: Introductionmentioning

confidence: 99%

Low-dose intravenous ketamine for postcardiac surgery pain: Effect on opioid consumption and the incidence of chronic pain

et al. 2017

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Background:Recent meta-analyses have concluded that low-dose intravenous ketamine infusions (LDKIs) during the postoperative period may help to decrease acute and chronic postoperative pain after major surgery.Aims:This study aims to evaluate the level of pain at least 3 months after surgery for patients treated with a postoperative LDKI versus patients who were not treated with a postoperative LDKI.Methods:Administrative and Ethics Board approval were obtained for this study. We performed a retrospective chart review for all patients receiving LDKI, and equal number of age-, sex-, and surgery-matched patients who did not receive LDKI. Low-dose ketamine was prepared using 100 mg of ketamine in 100 ml of normal saline and run between 50 and 200 mcg/kg/h.Results:We reviewed 115 patients with LDKI and 115 without LDKI. The average age was 63.1 years, 73% of the patients were men and sex was evenly distributed between LDKI and non-LDKI. The average duration of the ketamine infusions was 26.8 h with the average dose being 169.9 mg. At an average of 9 months after surgery, 42% of the ketamine group and 38% of the nonketamine group stated that they had had pain on discharge. Of these patients, 30% of the ketamine group and 26% of the nonketamine group still had pain at the time of the phone call. Women in both groups had more acute and chronic pain than men.Conclusion:These results show that LDKI does not promote a decrease in long-term postoperative pain.

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“…Mogahad MM etal had compared safety and efficacy of ketaminedexmedetomidine (KD) versus ketamine-propofol (KP) combinations for sedation in patients after coronary artery bypass graft surgery and concluded that KD provided short duration of mechanical ventilation with less fentanyl dose requirement in comparison with KP whereas hemodynamic stability and length of the ICU stay was same with both the regimens [76]. Future studies comparing ketamine to other commonly accepted sedative regiments, such as propofol and dexmedetomidine are critically needed in cardiac surgery patients [77]. Some authors have reported that a single dose of ketamine 0.5 mg/kg given upon induction was associated with lower serum levels of C-reactive protein and lower incidence of delirium and cognitive dysfunction after cardiac surgery with CPB.…”

Section: Some Other Clinical Uses Of Ketamine Available In Literaturementioning

confidence: 99%

Comeback of ketamine: resurfacing facts and dispelling myths

Kumar

Kohli

2021

Korean J Anesthesiol

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Initially known as CI-581, ketamine was first synthesized in 1962 as a replacement for phencyclidine (PCP). It is being used since then as a profound anesthetic and analgesic, in addition has bronchodilating, sedative and amnestic properties with the preservation of airway reflexes and sympathetic nervous system tone. Ketamine is always a stimulating topic of discussion since its discovery as the controversies regarding its usage in certain set of patients mostly overpowers its boon. In past 50 years, despite of potential benefits it has not gained acceptable popularity because of concerns of "emergence phenomenon", its use as substance of abuse and systemic side effects. Since 2012, ketamine has been subject to three World Health Organization (WHO) reviews addressing its international control. Researchers are widely studying this wonder drug since a decade worldwide. Many myths of ketamine regarding emergence phenomenon, its use in traumatic brain injury, open eye injury is getting busted in recent times. It's again getting popular in pre-hospital settings, critical care, emergency medicine, low dose acute pain services & adjuvant in regional anesthesia techniques. This review will highlight the current consensus on the various applications of ketamine in the light of available evidence in the literature.

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Ketamine in adult cardiac surgery and the cardiac surgery Intensive Care Unit: An evidence-based clinical review

Cited by 44 publications

References 46 publications

Chronic Poststernotomy Pain

Chronic Poststernotomy Pain

Low-dose intravenous ketamine for postcardiac surgery pain: Effect on opioid consumption and the incidence of chronic pain

Comeback of ketamine: resurfacing facts and dispelling myths

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