The effect of target-controlled infusion of low-dose ketamine on heat pain and temporal summation threshold

Lee, Joon-Ho; Cho, Sung-Hwan; Kim, Sang-Hyun; Chae, Won-Soek; Jin, Hee-Cheol; Lee, Jeong-Seok; Kim, Yong-Ik

doi:10.1007/s00540-011-1147-y

Cited by 7 publications

(7 citation statements)

References 37 publications

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“…; Lee et al. ). The nociceptive withdrawal reflex evoked by repeated stimuli has been used as a successful model to study the antinociceptive efficacy of ketamine in dogs, ponies and humans and would have been more appropriate to study the antinociceptive effects of ketamine in cats in this study.…”

Section: Discussionmentioning

confidence: 98%

“…Several studies in humans, dogs and ponies have revealed that ketamine suppresses the temporal summation of repetitive stimuli, rather than a single painful stimulus. (Arendt-Nielsen et al 1995;Bergadano et al 2009;Levionnois et al 2010;Lee et al 2011). The nociceptive withdrawal reflex evoked by repeated stimuli has been used as a successful model to study the antinociceptive efficacy of ketamine in dogs, ponies and humans and would have been more appropriate to study the antinociceptive effects of ketamine in cats in this study.…”

Section: Discussionmentioning

confidence: 99%

“…Currently there are no published investigations on the use of low dose rate ketamine infusions in conscious cats. Several studies have revealed that ketamine suppresses the temporal summation of repetitive stimuli, rather than a single painful stimulus (Arendt-Nielsen et al 1995;Bergadano et al 2009;Levionnois et al 2010;Lee et al 2011). Results of previous studies in cats (Robertson et al , 2003, however, indicate that thermal threshold testing might be a suitable model to test for ketamine-induced antinociception.…”

Section: Introductionmentioning

confidence: 99%

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Effect of low dose rate ketamine infusions on thermal and mechanical thresholds in conscious cats

Ambros

Duke

2013

Veterinary Anaesthesia and Analgesia

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effect of low dose rate ketamine infusions on thermal and mechanical thresholds in conscious cats

Ambros

Duke

2013

Veterinary Anaesthesia and Analgesia

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“…Automated ketamine anesthesia delivering systems (such as target-controlled infusion and closed-loops anesthesia systems) are under development ( 1,83 ). Several systems are already commercialized for racemic ketamine ( 88 ) or used in clinical research ( 51 ). They could potentially dramatically simplify GA delivery, increase its safety, and signifi cantly decrease crew training time and workload.…”

Section: Ketamine Future Perspectivesmentioning

confidence: 99%

Potential Anesthesia Protocols for Space Exploration Missions

Komorowski¹,

Watkins²,

Lebuffe³

et al. 2013

Aviation, Space, and Environmental Medicine

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In spaceflight beyond low Earth's orbit, medical conditions requiring surgery are of a high level of concern because of their potential impact on crew health and mission success. Whereas surgical techniques have been thoroughly studied in spaceflight analogues, the research focusing on anesthesia is limited. To provide safe anesthesia during an exploration mission will be a highly challenging task. The research objective is thus to describe specific anesthesia procedures enabling treatment of pre-identified surgical conditions. Among the medical conditions considered by the NASA Human Research Program Exploration Medical Capability element, those potentially necessitating anesthesia techniques have been identified. The most appropriate procedure for each condition is thoroughly discussed. The substantial cost of training time necessary to implement regional anesthesia is pointed out. Within general anesthetics, ketamine combines the unique advantages of preservation of cardiovascular stability, the protective airway reflexes, and spontaneous ventilation. Ketamine side effects have for decades tempered enthusiasm for its use, but recent developments in mitigation means broadened its indications. The extensive experience gathered in remote environments, with minimal equipment and occasionally by insufficiently trained care providers, confirms its high degree of safety. Two ketamine-based anesthesia protocols are described with their corresponding indications. They have been designed taking into account the physiological changes occurring in microgravity and the specific constraints of exploration missions. This investigation could not only improve surgical care during long-duration spaceflights, but may find a number of terrestrial applications in isolated or austere environments.

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“…1 Temporal summation, heat, and cold pain thresholds are increased after ketamine infusions. 12,13 QST changes associated with chronic opioid therapy include decreased heat pain threshold and exacerbated temporal summation of thermal stimulation. 3,11 However, the QST changes produced by ketamine in the setting of chronic opioid therapy have not been fully characterized and it is possible that chronic opioid use could offset the ketamine-induced changes in thermal thresholds and temporal summation.…”

mentioning

confidence: 99%

Chronic Opioid Therapy Modifies QST Changes After Ketamine Infusion in Chronic Pain Patients

Maher

Zhang

Ahmed

et al. 2017

The Journal of Pain

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The long-term effects of opioids on sensitization processes are believed to be mediated through the N-methyl-D-aspartate receptor. Quantitative sensory testing (QST) changes observed after a ketamine infusion have been previously described but the effect that chronic opioids will have is not known. The results of this prospective randomized factorial trial compared the thermal QST changes observed after a .05 mg/kg ketamine infusion or a saline placebo in chronic pain subjects who were either opioid-naive or were chronically using opioids for chronic noncancer pain are presented. No baseline QST differences were noted between the 4 groups at baseline. Comparison of changes preinfusion with postinfusion QST measurements resulted in decreased average change in temporal summation response between opioid subjects who received a placebo compared with those who received a ketamine infusion (−5.22, SD = 9.96 vs 13.81, SD = 19.55; P = .004). Additionally, the average change in temporal summation was decreased among subjects who received a ketamine infusion and were not chronically using opioids compared with subjects who were using chronic opioids and received a placebo infusion (−1.91, SD = 13.25 vs 13.81, SD = 19.55; P = .007). The results indicate that low-dose ketamine infusions produce subtle changes in QST phenotypes that are modified by the chronic use of opioids. This illustrates the potential diagnostic and therapeutic value of ketamine in the setting of chronic opioid use. Perspective: The presented data further our understanding of modulation of sensory perception in the setting of chronic opioid use and the role of the N-methyl-D-aspartate receptor. The use of low-dose ketamine infusions may be useful for the treatment as well as diagnosis of opioid-related neuropathic conditions.

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The effect of target-controlled infusion of low-dose ketamine on heat pain and temporal summation threshold

Abstract: TCI of ketamine with a Ce of 30 and 60 ng/ml increased TST but not HPT.

Cited by 7 publications

References 37 publications

Effect of low dose rate ketamine infusions on thermal and mechanical thresholds in conscious cats

Effect of low dose rate ketamine infusions on thermal and mechanical thresholds in conscious cats

Potential Anesthesia Protocols for Space Exploration Missions

Chronic Opioid Therapy Modifies QST Changes After Ketamine Infusion in Chronic Pain Patients

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