Use of a combination of ketamine and dexmedetomidine (Ketodex) in different clinical cases

Amornyotin, Somchai

doi:10.17352/2455-3484.000036

Cited by 4 publications

(3 citation statements)

References 28 publications

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“…In this case, the combination of ketamine and dexmedetomidine was used to balance out each other's side effects and provide several benefits such as hemodynamic stability, no respiratory depression, postoperative analgesia, and smooth recovery [ 18 ]. Dexmedetomidine helped prevent tachycardia and hypertension caused by ketamine, while ketamine prevented bradycardia and hypotension caused by dexmedetomidine.…”

Section: Discussionmentioning

confidence: 99%

Continuous Erector Spinae and Serratus-Intercostal Block With Ketamine-Dexmedetomidine Sedation for Quadrantectomy and Axillary Dissection in a Multimorbid Patient

D'Agostino,

Scimia,

De Cato

et al. 2023

Cureus

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Multimorbidity is a clinical presentation that poses an increased risk of perioperative and postoperative complications. Tailored anaesthetic management could potentially minimise the risk of negative outcomes. Peripheral nerve and fasciae blocks are valid strategies for perioperative and postoperative pain management, which avoid complications related to general anaesthesia and reduce the risk of intensive care unit admission as well as the hospital length of stay. We describe the case of a 56-old patient with multimorbidity, including obesity with a BMI of 45.7, unstable angina, predicted difficult airway management and obstructive sleep apnoea syndrome (OSAS) scheduled for left mastectomy with sentinel lymph node biopsy, managed with a left continuous thoracic erector spinae plane (ESP) block plus serratus-intercostal plane block (BRanches of Intercostal nerves at the Level of Mid-Axillary line (BRILMA)), and sedation with combined ketamine-dexmedetomidine. Fascial blocks combined with opioid-free anaesthesia (OFA) proved to be effective for the multimorbid patient, ensuring successful perioperative management and a proper recovery after surgery.

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Section: Discussionmentioning

confidence: 99%

Continuous Erector Spinae and Serratus-Intercostal Block With Ketamine-Dexmedetomidine Sedation for Quadrantectomy and Axillary Dissection in a Multimorbid Patient

D'Agostino,

Scimia,

De Cato

et al. 2023

Cureus

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“…The results showed that nasal administration of 1 mg/kg of right ketamine had a certain sedative effect, but depth of sedation was not enough to separate children from their parents. [19] The children with intussusception were divided into two groups. One was given morphine of 0.05 ~ 0.1mg/kg for analgesia, and other was given right ketamine of 0.5 ~ 1mg/kg intravenously for sedation and tranquilization.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of effect of ketamine combined with different sedative and anesthetic drugs in children's short surgery

Zheng,

Fu,

et al. 2023

Preprint

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OBJECTIVE To study anesthesia effect and safety of ketamine combined with dexmedetomidine in short surgery in children. Methods Selected 60 cases of American Society of Anesthesiologists (ASA) I ~ II grades, children with short surgery, aged 2 ~ 7 years, weighing 10 ~ 30kg, and divided into three groups according to random double-blind method, 20 cases in each. All patients received intramuscular injection of ketamine 4–5 mg • kg", atropine 0.01 mg • kg" and midazolam 0.05 mg • kg" before operation. After child enters operating room, he/she will be given oxygen inhalation by mask with oxygen flow rate of 1 ~ 2L/min, and establish a venous pathway. He/she will be given 10% glucose injection 100ml intravenous drip. A: ketamine 1.5 mg • kg "was given intravenously before skin incision, and same amount of normal saline was continuously pumped intravenously; B: ketamine 1.5 mg • kg was given intravenously before skin incision, and dexmedetomidine was pumped intravenously at a load of 0.5µg • kg for 15 min, and then operation was completed at a speed of 0.25 pg • kg • h '; C: Ketamine 1.5 mg/kg was given intravenously before skin incision, and dexmedetomidine was pumped intravenously at a load of 1µg • kg for 15 min, then operation was completed at a speed of 0.5 pg • kg • h '. During operation, 1.5 mg • kg ketamine was given intravenously and intermittently according to degree of anesthesia and surgical stimulation of children. During perioperative period, ECG, mean arterial pressure (MAP), heart rate (HR) and pulse oxygen saturation (\(Sp{O_2}\)) of children were continuously monitored, and dose of ketamine added during operation, postoperative waking time and sedation degree score (Ramsay sedation score), as well as preoperative and postoperative blood glucose values were recorded. Results There was no change in \(Sp{O_2}\) during perioperative period; The MAP and HR increased during perioperative period. Compared with increase of MAP and HR, A > B > C, but no difference between A and B, and a difference between A and C; Compared with dosage of additional phenone, dosage of A was much higher than B and C; The Ramsay sedation scores of children after operation showed that A < B < C; The recovery time of children in C was longer than A and B; Compared blood glucose changes before and after operation, A was higher than B and C. Conclusion Dextrmedetomidine pumped with 0.5µg · kg load and 0.25µg · kg maintenance can reduce occurrence of restlessness after ketamine operation without respiratory inhibition, and has no effect on recovery time after operation, and can inhibit stress of hand operation to a certain extent. It can be safely used for anesthesia of children's short operation.

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“…Dexmedetomidine is a selective alpha-2 adrenergic receptor agonist drug with sedative, analgesic, and anxiolytic effects. Due to its notable advantages like hemodynamic stability, postoperative pain relief, and absence of respiratory depression, the combination of intravenous ketamine and dexmedetomidine is often utilized [5]. There are several studies in the literature on the combination of ketamine and dexmedetomidine in the pediatric population [6][7][8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Intravenous Dexmedetomidine-Ketamine Versus Ketamine-Propofol for Procedural Sedation in Adults Undergoing Short Surgical Procedures: A Randomized Controlled Trial

Kakarla,

Senapati,

Das

et al. 2023

Cureus

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Background and objectiveModerate to deep sedation is a prerequisite during total intravenous anesthesia for short-duration surgeries, and it can be achieved by using individual drugs or in combination. Our study compared dexmedetomidineketamine (DK) versus ketamine-propofol (KP) in terms of sedation, procedural interference, hemodynamics, and incidence of side effects in patients undergoing short surgical procedures. MethodsA total of 194 patients scheduled for short-duration elective surgeries were randomly allocated into two groups. Group DK received a loading dose of 1 µg/kg of dexmedetomidine and 1 mg/kg of ketamine followed by a maintenance infusion of dexmedetomidine at 0.3 µg/kg/h. Group KP received a loading dose of 1 mg/kg of ketamine and 1 mg/kg of propofol followed by a maintenance infusion of propofol at 25 µg/kg/h. For procedural interference, a rescue ketamine bolus was administered at 0.25 mg/kg. Patients were monitored for the requirement of rescue ketamine bolus, procedural interference, hemodynamics, sedation, recovery time, and adverse effects. ResultsThe procedural interference was higher in group KP than in group DK and the difference was statistically significant (P=0.001). The time to the first rescue bolus was 8.72 ± 4.47 minutes in group KP and 10.82 ± 4.01 minutes in group DK, with a difference of 2.1 minutes (p=0.026). There was no statistically significant difference in the sedation scores between both groups except at time points of six minutes and 15 minutes. ConclusionFor short-duration procedures, the DK combination is superior to the KP combination in terms of procedural interference and time to the first rescue bolus, while both groups were comparable with regard to safety and hemodynamics.

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Use of a combination of ketamine and dexmedetomidine (Ketodex) in different clinical cases

Cited by 4 publications

References 28 publications

Continuous Erector Spinae and Serratus-Intercostal Block With Ketamine-Dexmedetomidine Sedation for Quadrantectomy and Axillary Dissection in a Multimorbid Patient

Continuous Erector Spinae and Serratus-Intercostal Block With Ketamine-Dexmedetomidine Sedation for Quadrantectomy and Axillary Dissection in a Multimorbid Patient

Evaluation of effect of ketamine combined with different sedative and anesthetic drugs in children's short surgery

Intravenous Dexmedetomidine-Ketamine Versus Ketamine-Propofol for Procedural Sedation in Adults Undergoing Short Surgical Procedures: A Randomized Controlled Trial

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