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Littérature scientifique sur le sujet « Intravenous Ketamine »

Auteur : Grafiati

Publié le 14 mars 2023

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Articles de revues sur le sujet "Intravenous Ketamine"

Zhang, Shi-Xia, Xin Li, Qing-Ming Ren, Dong-Liang Niu, Li Gao et Hong-Bin Wang. « Changes of lidocaine concentration and physiological indices in dogs during anaesthesia with lidocaine and isoflurane combined with ketamine or fentanyl ». Acta Veterinaria Brno 85, n^o 1 (2016) : 91–97. http://dx.doi.org/10.2754/avb201685010091.

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Fentanyl and ketamine are often used as adjuvants in intravenous anaesthesia to prolong analgesia. The aim of this study was to compare changes of the basic physiological variables of intravenous lidocaine administration in combination with ketamine or fentanyl, and to evaluate the impact of addition of fentanyl or ketamine to lidocaine on serum lidocaine concentrations in dogs after intravenous administration. During general anaesthesia, dogs of group L received 2% lidocaine intravenously, dogs of group LF received 2% lidocaine and fentanyl, and dogs of the group LK received 2% lidocaine and ketamine. The heart rate, systolic arterial pressure, diastolic arterial pressure, mean arterial pressure and rectal temperature decreased in all groups, and group LF showed the biggest effect on the basic physiological variables, with the lowest heart rate during the test, significantly decreased rectal temperature, and the most decreased values of arterial pressure. Blood for determination of serum lidocaine concentration was taken before anaesthesia and 5, 30, 60, 90, 120, 150 and 180 min after initial intravenous injection of drugs. Fentanyl and ketamine did not cause significant changes of serum lidocaine concentration in dogs and may be used as adjuvant in intravenous anaesthesia without a significant increase in lidocaine absorption.

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Opler, Lewis A., Mark G. A. Opler et Amy F. T. Arnsten. « Ameliorating treatment-refractory depression with intranasal ketamine : potential NMDA receptor actions in the pain circuitry representing mental anguish ». CNS Spectrums 21, n^o 1 (26 janvier 2015) : 12–22. http://dx.doi.org/10.1017/s1092852914000686.

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This article reviews the antidepressant actions of ketamine, an N-methyl-D-aspartame glutamate receptor (NMDAR) antagonist, and offers a potential neural mechanism for intranasal ketamine’s ultra-rapid actions based on the key role of NMDAR in the nonhuman primate prefrontal cortex (PFC). Although intravenous ketamine infusions can lift mood within hours, the current review describes how intranasal ketamine administration can have ultra-rapid antidepressant effects, beginning within minutes (5–40 minutes) and lasting hours, but with repeated treatments needed for sustained antidepressant actions. Research in rodents suggests that increased synaptogenesis in PFC may contribute to the prolonged benefit of ketamine administration, beginning hours after administration. However, these data cannot explain the relief that occurs within minutes of intranasal ketamine delivery. We hypothesize that the ultra-rapid effects of intranasal administration in humans may be due to ketamine blocking the NMDAR circuits that generate the emotional representations of pain (eg, Brodmann Areas 24 and 25, insular cortex), cortical areas that can be overactive in depression and which sit above the nasal epithelium. In contrast, NMDAR blockade in the dorsolateral PFC following systemic administration of ketamine may contribute to cognitive deficits. This novel view may help to explain how intravenous ketamine can treat the symptoms of depression yet worsen the symptoms of schizophrenia.

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Jiang, S., K. Hu, HG Fan, BS Yin, X. Li, JL Hou et HB Wang. « Effects of ketamine/xylazine premedication on emulsified isoflurane general anaesthesia in swine undergoing embryo transplantation ». Veterinární Medicína 59, No. 7 (16 septembre 2014) : 325–30. http://dx.doi.org/10.17221/7618-vetmed.

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Cardiorespiratory effects were assessed during ketamine/xylazine premedication followed by emulsified isoflurane anaesthesia in swine undergoing experimental embryo transplantation. Ketamine (10 mg/kg) and xylazine (3.5 mg/kg) were premedicated intravenously, followed by continuous administration of intravenous emulsified isoflurane (2.8 ml/kg/h). Cardiorespiratory parameters, including heart rate, respiratory rate, mean arterial blood pressure, arterial oxygen saturation, and rectal temperature, were recorded in sows undergoing surgical embryo transplantation. Ketamine/xylazine premedication resulted in anaesthetic induction and lateral recumbency within 1 minute without any adverse effects. The physiological changes observed after drug administration remained within biologically acceptable limits. In conclusion, the combination of ketamine/xylazine provided anaesthetic induction, muscle relaxation, and analgesia sufficient for emulsified isoflurane intravenous anaesthesia. There were no adverse events in the experimental animals. This finding supports the use of emulsified isoflurane following ketamine/xylazine premedication in pigs.

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Kornhall, Daniel, et Erik Waage Nielsen. « Failure of Ketamine Anesthesia in a Patient with Lamotrigine Overdose ». Case Reports in Critical Care 2014 (2014) : 1–3. http://dx.doi.org/10.1155/2014/916360.

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Introduction.It is important to know which clinical situations prevent ketamine from working.Case Report.We present the case of the psychiatric inpatient who was admitted to our emergency department after ingesting a toxic dose of lamotrigine, unknown at that time. On admission, she was clearly in distress, displaying extreme agitation and violent ataxic movements. We opted to achieve sedation using intravenous ketamine boluses. Unexpectedly, after being injected with a total of 250 mg ketamine, our patient displayed no signs of dissociative anaesthesia.Discussion.There was no apparent reason for why ketamine failed, but an interaction between lamotrigine and ketamine was suspected. A literature search was performed. Very few articles describe interactions between lamotrigine and ketamine. Experimental studies, however, demonstrate how lamotrigine attenuates the neuropsychiatric effects of ketamine. Ketamine is classically described as an NMDA antagonist. Ketamine’s dissociative effects, however, are thought to be mediated by increased glutamate release via a pathway not dependent on NMDA receptors. Lamotrigine, on the other hand, is known to reduce cortical glutamate release.Conclusion.Lamotrigine reduces the glutamate release needed to mediate ketamine’s dissociative anaesthesia. This is important knowledge for anaesthesiologists in the emergency room where ketamine is often administered to unstable patients.

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Stahl, Stephen M. « Mechanism of action of dextromethorphan/quinidine : comparison with ketamine ». CNS Spectrums 18, n^o 5 (20 septembre 2013) : 225–27. http://dx.doi.org/10.1017/s109285291300062x.

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ISSUE:Reports of rapid-onset but short-duration antidepressant effects in patients with treatment-resistant mood disorders after intravenous administration of ketamine have prompted efforts to find an agent with ketamine's properties that can be administered orally in repeated doses in order to sustain that action. One candidate for this is dextromethorphan, and here the pharmacologic mechanism of action is compared and contrasted with that of ketamine.

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Tindale, Rabina. « Intravenous ketamine in adults ». Emergency Nurse 16, n^o 5 (13 septembre 2008) : 4. http://dx.doi.org/10.7748/en.16.5.4.s9.

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Ball, Christine, et Rod Westhorpe. « Intravenous Induction Agents : Ketamine ». Anaesthesia and Intensive Care 30, n^o 2 (avril 2002) : 115. http://dx.doi.org/10.1177/0310057x0203000201.

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Park, J.-W., Y.-H. Jung, C.-W. Baek, H. Kang et S.-M. Cha. « Effects of Low Dose Ketamine on Tourniquet-induced Haemodynamic Responses during General Anaesthesia ». Journal of International Medical Research 35, n^o 5 (septembre 2007) : 600–608. http://dx.doi.org/10.1177/147323000703500504.

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This study investigated the effect of a pre-operative low dose of intravenous ketamine on tourniquet-induced haemodynamic changes. Ten minutes after induction of general anaesthesia, 0.1 mg/kg ketamine in 10 ml of saline (ketamine group, n = 14) or 10 ml of normal saline (control group, n = 14) were administered intravenously. Systolic and diastolic blood pressures, and heart rate relative to tourniquet inflation and deflation were recorded and compared within and between groups. Systolic and diastolic blood pressures in the control group significantly increased relative to baseline during the observation period following tourniquet inflation, but generally did not significantly increase in the ketamine group. The control group had a greater percentage of patients with a 30% rise in blood pressure at 60 min after tourniquet inflation compared with the ketamine group (28.6% vs 7.1%), but this was not statistically significant. We conclude that a pre-operative low dose (0.1 mg/kg) of intravenous ketamine can prevent a systemic arterial pressure increase for at least 60 min after tourniquet inflation under general anaesthesia.

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Mwase, Richard, Tonny Stone Luggya, John Mark Kasumba, Humphrey Wanzira, Andrew Kintu, Joesph V. B. Tindimwebwa et Daniel Obua. « Analgesic Effects of Preincision Ketamine on Postspinal Caesarean Delivery in Uganda’s Tertiary Hospital : A Randomized Clinical Trial ». Anesthesiology Research and Practice 2017 (2017) : 1–6. http://dx.doi.org/10.1155/2017/5627062.

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Background. Good postoperative analgesic management improves maternal satisfaction and care of the neonate. Postoperative pain management is a challenge in Mulago Hospital, yet ketamine is accessible and has proven benefit. We determined ketamine’s postoperative analgesic effects.Materials and Methods. We did an RCT among consenting parturients that were randomized to receive either intravenous ketamine (0.25 mg/kg) or placebo after spinal anesthetic. Pain was assessed every 30 mins up to 24 hours postoperatively using the numerical rating scale. The first complaint of pain requiring treatment was noted as “time to first breakthrough pain.”Results. We screened 100 patients and recruited 88 that were randomized into two arms of 44 patients that received either ketamine or placebo. Ketamine group had 30-minute longer time to first breakthrough pain and lower 24-hour pain scores. Postoperative diclofenac consumption was lesser in the ketamine group compared to placebo and Kaplan-Meier graphs showed a higher probability of experiencing breakthrough pain earlier in the placebo group.Conclusion. Preincision intravenous ketamine (0.25 mg/kg) offered 30-minute prolongation to postoperative analgesia requirement with reduced 24-hour pain scores. We recommend larger studies to explore this benefit. This trial is registered with Pan African Clinical Trial Registry numberPACTR201404000807178.

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AHMED, FAROOQ. « (TIVA) INTRAVENOUS ANAESTHESIA ». Professional Medical Journal 13, n^o 03 (25 juin 2006) : 341–43. http://dx.doi.org/10.29309/tpmj/2006.13.03.4978.

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To compare the combination of propofol ketamine , propofolfentanyl and propofol vs midazolam for TIVA in terms of haemodynamic changes, analgesia and recoverycharacteristics. Design A randomized clinical control trial. Setting CMH Rawalpindi. Period. September 2002 toAugust 2003.Material and Methods. The present study consisted of 75 patients of both sexes between the age groupof 18-55 years belonging to ASA grade I and II, who were scheduled for various short surgical procedures. Results.Combination of propofol and ketamine provides better haemodynamic stability throughout the procedure, whencompared to propofol fentanyl. Induction time was significantly shorter in the propofol group. Mean recovery time wassignificantly faster with propofol (12.3 min) compared to midazolam (20.4 min).. Conclusion. Combination of propofoland ketamine gives better haemodynamic stability during induction and maintenance of total intravenous anaesthesia.Both propofol and midazolam are safe and effective for TIVA in children. Recovery was faster and more comfortablefollowing propofol

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Thèses sur le sujet "Intravenous Ketamine"

Cuomo, Alessandro. « "TREATMENT-RESISTANT DEPRESSION" AND USE OF INTRAVENOUS KETAMINE AND INTRANASAL ES-KETAMINE ». Doctoral thesis, Università di Siena, 2021. http://hdl.handle.net/11365/1148507.

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Treatment-Resistant Depression (TRD) is defined as major depression characterized by the unsatisfactory response of two or more antidepressant therapies (adequate for dosage and duration), associated with a high incidence of comorbidities, with more marked impairment of functioning socio-occupational and greater risks of relapse, recurrence and suicidality. The high incidence of TRD has advanced scientific research towards the study of molecules with antidepressant action and with different mechanisms of action than those based on the monoaminergic theory. Ketamine is one of these molecules. A non-competitive antagonist of the glutamate N-methyl-D-aspartate (NMDA) receptor, ketamine is mainly used in clinical practice as an anaesthetic and analgesic agent. It has recently been shown that it exerts an antidepressant activity with few and transient side effects at sub anaesthetic doses. Esketamine is the S-enantiomer of ketamine and has recently been FDA approved in the United States for treating depression that has failed to respond to trials of two or more antidepressants. Although the complete molecular mechanism of ketamine is very complex and still partly unknown, it appears that NMDA blockade induces a modulation of several synaptogenic signalling pathways, such as brain-derived neurotrophic factor (BDNF), improving synaptic plasticity of the prefrontal cortex and hippocampus. The design of the observational and retrospective study object of this thesis is evaluating the clinical response following repeated administration of intravenous ketamine (off-label use) and intranasal esketamine in a sample of 16 patients referring to the Psychiatric Clinic of the Siena University Hospital suffering from TRD. The efficacy assessment was performed by administering the Montgomery-Asberg Depression Rating Scale (MADRS) by an expert clinician before and during each entire treatment cycle of ketamine or esketamine intake. The data appeared to be significant in terms of benefit deriver from intravenous ketamine or intranasal S-ketamine therapy. In particular on the core symptoms of depression, such as sadness, apathy, inability to concentrate and fatigue, as shown by a reduction in the total score MADRS at last dose> 27% of baseline score. The most significant effects were achieved in the first 4 weeks of administration. The study limit is the small number of samples, which are still being implemented. To date, ketamine and S-ketamine are proven to be one of the few innovative drug therapies effective and safe for the treatment of TRD.

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Buck, Roxanne Kate. « Propofol-medetomidine-ketamine total intravenous anaesthesia in thiafentanil-medetomidine immobilised impala (Aepyceros melampus) ». Diss., University of Pretoria, 2015. http://hdl.handle.net/2263/53318.

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Objective To characterise a propofol-medetomidine-ketamine total intravenous anaesthetic protocol in impala (Aepyceros melampus). Study design Prospective clinical study. Animals Ten adult female impala, weighing 39 (±4) kg. Materials and methods Impala were immobilised with 2 mg thiafentanil and 2.2 mg medetomidine via projectile darts. Propofol was given to effect (0.5 mg kg-1 boluses) to allow endotracheal intubation, following which oxygen was supplemented at 2 L min-1. Anaesthesia was maintained with a constant rate infusion of medetomidine and ketamine at 5 ?g kg-1 h-1 and 1 mg kg-1 h-1, respectively, and propofol to effect (initially 0.2 mg kg-1 min-1) for a period of 120 minutes. The propofol infusion was titrated according to reaction to nociceptive stimuli every 15 minutes. Cardiopulmonary parameters were monitored continuously and arterial blood gas samples analysed intermittently. At 120 minutes maintenance the thiafentanil and medetomidine were antagonised using naltrexone (10:1 thiafentanil) and atipamezole (5:1 medetomidine), respectively, and recoveries scored. Results All impala were successfully immobilised, with a median (IQR) time to recumbency of 9.6 (7.2-14.4) minutes. The median (IQR) dose of propofol required for intubation was 2.7 (1.9-3.3) mg kg-1. The propofol-medetomidine-ketamine combination ensured recumbency for the 120 minute period. Propofol titration showed an erratic downward trend; a minimum infusion rate was not determined. Heart rate, respiratory rate and arterial blood pressure were well maintained. Arterial blood gas analysis indicated marked hypoxaemia, hypercapnia and acidosis. All impala regurgitated frequently during the maintenance period. Recovery was calm and rapid in all animals. Median (IQR) time to standing from antagonist administration was 9.4 (8.2-10.6) minutes. Conclusions and clinical relevance A propofol-medetomidine-ketamine combination can provide adequate anaesthesia for invasive procedures in impala for up to 120 minute duration. The propofol infusion should begin at 0.2 mg kg-1 min-1 and be titrated to clinical effect. Oxygen supplementation and airway protection with a cuffed endotracheal tube are essential.
Dissertation (MSc)--University of Pretoria, 2015.
tm2016
Companion Animal Clinical Studies
MSc

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Silva, Fernando do Carmo [UNESP]. « Infusão contínua em cadelas submetidas à ovário-salpingo-histerectomia com midazolam-xilazina-cetamina ou midazolam-medetomidina-cetamina, pré-tratadas com levomepromazina e buprenorfina ». Universidade Estadual Paulista (UNESP), 2007. http://hdl.handle.net/11449/97721.

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Made available in DSpace on 2014-06-11T19:29:05Z (GMT). No. of bitstreams: 0 Previous issue date: 2007-02-16Bitstream added on 2014-06-13T20:18:51Z : No. of bitstreams: 1 silva_fc_me_botfm.pdf: 464982 bytes, checksum: fb68f4ccbfb4784874fcd6f35ea4bef2 (MD5)
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
Objetivou-se um estudo com infusão contínua de xilazina ou medetomidina associada à cetamina e midazolam, para a constatação do grau de hipnose, miorrelaxamento e qualidade anestésica verificada através do conforto do paciente durante a anestesia, bem como, a verificação das alterações paramétricas, qualidade de recuperação e segurança dos mesmos. Foram utilizadas 20 cadelas, clinicamente sadias, descartando-se as gestantes ou em fase estral. Os animais foram distribuídos de forma aleatória em dois grupos de 10 animais cada (n=10), designados como GI e GII. Os animais de GI foram submetidos a um pré-tratamento com levomepromazina e buprenorfina pela via intravenosa e induzidos à anestesia com cetamina e midazolam em bolus pela mesma via e mantidos por infusão contínua de midazolam-cetamina-xilazina por um período de 30 minutos. Em GII utilizou-se a mesma técnica empregada em GI substituindo-se, porém a xilazina pela medetomidina. A monitoração foi realizada durante todo o período experimental sendo que a colheita dos dados em momentos onde, M0, imediatamente antes do pré-tratamento; M1 decorridos 15 minutos após a administração do pré-tratamento e imediatamente anterior à indução. Em ato contínuo após a indução à anestesia iniciou-se a administração por via intravenosa contínua, sendo realizadas as aferições dos parâmetros em intervalos de 10 minutos referentes à M2 até M4. Conclui-se que, o GII apresentou vantagens clínicas sobre GI por apresentar um menor período de recuperação, menor incidência de efeitos indesejáveis na recuperação anestésica. Ambos os protocolos empregados permitiram a realização do ato cirúrgico (ovário-salpingo-histerectomia) embora ambos os grupos tenham apresentados arritmias dentro de algum momento estudado em GII este ocorreu com menor incidência.
The objective of the present study was to verify the degree of hypnosis, muscle relaxation and quality of anesthesia while using a continuous infusion of xylazine and medetomidine associated with ketamine and midazolam. Those parameters were evaluated by patient well - being throughout anesthesia added to the parametric alterations, recovery quality and security. Twenty bitches were used, being clinically healthy, with exception of all pregnant females and bitches in estrus. The animals were randomly assigned into two groups (G1 and G2), with 10 animals per group. The females in G1 were submitted to pre- treatment with methotrimeprazine and buprenorphine (IV), being induced to anesthesia with ketamine and midazolam in bolus both by intra-venous administration during 30 minutes. The animals from group 2 received the same protocol used for G1 animals, except for the replacement of xylazine by medetomidine. The bitches were monitored during all experimental period at determined moments: M0, immediately before pre-treatment; M1, 15 minutes after pre-treatment administration and immediately before induction. The intra-venous and continuos administration started right after induction of anesthesia, and the parameters were evaluated within 10 minutes interval which corresponded to M 2 and M4. In conclusion, G2 presented advantages, at least considering clinical aspects in relationship to G1 due to a shorter recovery period followed by less side effects incidence during this period. Both protocols allowed surgery to be performed (hysterectomy). Even tough an arrhythmia was observed at determined moment in both groups, G2 had the lowest incidence of this side effect, requiring further studies to clarify such effects.

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Silva, Fernando do Carmo. « Infusão contínua em cadelas submetidas à ovário-salpingo-histerectomia com midazolam-xilazina-cetamina ou midazolam-medetomidina-cetamina, pré-tratadas com levomepromazina e buprenorfina / ». Botucatu : [s.n.], 2007. http://hdl.handle.net/11449/97721.

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Orientador: Flavio Massone
Banca: Valéria Nobre Leal de Souza Oliva
Banca: André Leguthe Rosa
Resumo: Objetivou-se um estudo com infusão contínua de xilazina ou medetomidina associada à cetamina e midazolam, para a constatação do grau de hipnose, miorrelaxamento e qualidade anestésica verificada através do conforto do paciente durante a anestesia, bem como, a verificação das alterações paramétricas, qualidade de recuperação e segurança dos mesmos. Foram utilizadas 20 cadelas, clinicamente sadias, descartando-se as gestantes ou em fase estral. Os animais foram distribuídos de forma aleatória em dois grupos de 10 animais cada (n=10), designados como GI e GII. Os animais de GI foram submetidos a um pré-tratamento com levomepromazina e buprenorfina pela via intravenosa e induzidos à anestesia com cetamina e midazolam em bolus pela mesma via e mantidos por infusão contínua de midazolam-cetamina-xilazina por um período de 30 minutos. Em GII utilizou-se a mesma técnica empregada em GI substituindo-se, porém a xilazina pela medetomidina. A monitoração foi realizada durante todo o período experimental sendo que a colheita dos dados em momentos onde, M0, imediatamente antes do pré-tratamento; M1 decorridos 15 minutos após a administração do pré-tratamento e imediatamente anterior à indução. Em ato contínuo após a indução à anestesia iniciou-se a administração por via intravenosa contínua, sendo realizadas as aferições dos parâmetros em intervalos de 10 minutos referentes à M2 até M4. Conclui-se que, o GII apresentou vantagens clínicas sobre GI por apresentar um menor período de recuperação, menor incidência de efeitos indesejáveis na recuperação anestésica. Ambos os protocolos empregados permitiram a realização do ato cirúrgico (ovário-salpingo-histerectomia) embora ambos os grupos tenham apresentados arritmias dentro de algum momento estudado em GII este ocorreu com menor incidência.
Abstract: The objective of the present study was to verify the degree of hypnosis, muscle relaxation and quality of anesthesia while using a continuous infusion of xylazine and medetomidine associated with ketamine and midazolam. Those parameters were evaluated by patient well - being throughout anesthesia added to the parametric alterations, recovery quality and security. Twenty bitches were used, being clinically healthy, with exception of all pregnant females and bitches in estrus. The animals were randomly assigned into two groups (G1 and G2), with 10 animals per group. The females in G1 were submitted to pre- treatment with methotrimeprazine and buprenorphine (IV), being induced to anesthesia with ketamine and midazolam in bolus both by intra-venous administration during 30 minutes. The animals from group 2 received the same protocol used for G1 animals, except for the replacement of xylazine by medetomidine. The bitches were monitored during all experimental period at determined moments: M0, immediately before pre-treatment; M1, 15 minutes after pre-treatment administration and immediately before induction. The intra-venous and continuos administration started right after induction of anesthesia, and the parameters were evaluated within 10 minutes interval which corresponded to M 2 and M4. In conclusion, G2 presented advantages, at least considering clinical aspects in relationship to G1 due to a shorter recovery period followed by less side effects incidence during this period. Both protocols allowed surgery to be performed (hysterectomy). Even tough an arrhythmia was observed at determined moment in both groups, G2 had the lowest incidence of this side effect, requiring further studies to clarify such effects.
Mestre

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Enderle, Alke Karen. « Clinical evaluation of ketamine and lidocaine intravenous infusions to reduce isoflurane requirements in horses under general anaesthesia / ». Bern : [s.n.], 2006. http://www.ub.unibe.ch/content/bibliotheken_sammlungen/sondersammlungen/dissen_bestellformular/index_ger.html.

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Erdoğan, Nilüfer Özmen Sadık. « Önkol cerrahisinde %0.375 ropivakain ve %0.375 ropivakain + (+)S-ketamine ile oluşturulan rejyonal intravenöz anestezinin klinik etkilerinin karşılaştırılması / ». Isparta : SDÜ Tıp Fakültesi, 2006. http://tez.sdu.edu.tr/Tezler/TT00253.pdf.

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Swart, Ellison Margaret. « The efficacy and safety of intravenous sedation in children under the age of 10 years ». Thesis, University of the Western Cape, 2013. http://hdl.handle.net/11394/5044.

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Magister Scientiae Dentium - MSc(Dent)
This study was done to show that sedation is a safe and a viable option in young children. Dental procedures were done on children aged two to ten years. Two hundred children were included in the study. In all of these children the procedures were completed. Only two children were excluded, because an intravenous line could not be placed on the one child, and the other child was unmanageable under sedation. The safety of sedation was evaluated looking at the incidence of adverse events and complications. No serious adverse effects or complications occurred. The complications that occurred were all corrected with minimal or non-invasive interventions. Only six of the two hundred children required oxygen to correct a drop in oxygen saturation.

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Venter, J. C. « The safety and efficacy of the propofol/ Alfentanil/ Ketamine-bolus technique in midazolam pre-medicated patients undergoing office based plastic or reconstructive surgery ». Thesis, University of the Western Cape, 2007. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_8596_1255685962.

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The purpose of this research project was to assess the safety and efficacy of a combination of drugs for conscious sedation in patients undergoing office-based plastic and reconstructive surgery. A pilot study was done to determine the safety of the co-administration of the drugs used in the sedation technique.

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Bester, E. J. « Multidrug sedation for dental procedures in children younger than eight ». Thesis, University of the Western Cape, 2005. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_1512_1181913752.

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In this case study research project I have determined that multidrug sedation in children younger than eight years are possible.
Conscious sedation [or sedation where verbal contact with the patient is possible] can be used successfully to decrease anxiety and fear for unpleasant experiences, like dental procedures.

Behaviour therapy in conjunction with one or more drugs can be used to depress the central nervous system in order to decrease the patient&rsquo
s awareness of unpleasant stimuli. This enables treatment to be carried out without patient interference. Extensive literature surveys were done to determine the ideal drugs as well as the ideal route for conscious sedation in dental treatment for children. In this study project drugs like midazolam, propofol, alfentanyl and ketamine were titrated intravenously to achieve conscious sedation.

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Soto, Cabrera María Alejandra. « Descripción del comportamiento anestésico del conejo doméstico (Oryctolagus cuniculus) frente a la inducción y redosificación con ketamina intravenosa (IV) ». Tesis, Universidad de Chile, 2010. http://repositorio.uchile.cl/handle/2250/131375.

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Memoria para optar al Título Profesional de Médico Veterinario
En este estudio se describen las características de la anestesia quirúrgica mantenida durante una hora en conejos premedicados con atropina en dosis de 0,04 mg/kg y acepromacina en dosis de 0,2 mg/kg administradas por vía intramuscular, e inducidos con ketamina intravenosa y redosificados con ketamina intravenosa. Se registraron las frecuencias cardiaca y respiratoria cada 5 minutos y la temperatura rectal cada 15 minutos. Asimismo, se registraron la dosis de inducción anestésica endovenosa, el tiempo de anestesia quirúrgica obtenido con la dosis de inducción, las dosis de mantención anestésica endovenosa, el número de redosificaciones anestésicas y la dosis anestésica total. Con los datos obtenidos para cada variable se calculó el promedio, la desviación estándar y el coeficiente de variación. La dosis de inducción anestésica (D.I.A.) fue de 18,76 ± 26,53 mg/kg (promedio ± desviación estándar), con un coeficiente de variación (CV) de 141,44%, y otorgando un tiempo de anestesia quirúrgica obtenido con la dosis de inducción anestésica (T.A.D.I.A.) de 11,73 ± 9,05 minutos (CV = 77,14%). Se obtuvo un promedio de 5,35 ± 1,92 redosificaciones (CV = 35,86%) y una dosis anestésica total (D.A.T.) de 58,46 ± 44,38 mg/kg (CV = 75,92%) para mantener un plano anestésico quirúrgico durante 60 minutos de cirugía. En relación con las variables fisiológicas, para todas ellas el análisis de varianza (ANDEVA) arrojó diferencias significativas entre tiempos. La frecuencia cardiaca (FC) basal fue de 225 ± 40,74 latidos por minuto (lpm), siendo a los 60 minutos de cirugía igual a 193 ± 25,62 lpm; la frecuencia respiratoria (FR) basal fue de 135 ± 40 respiraciones por minuto (rpm), mientras que a los 60 minutos fue de 67 ± 19 rpm; y con respecto a la temperatura, ésta se presentó a nivel basal en 37,3 ± 1,1 ºC, siendo a los 60 minutos igual a 34,2 ± 1,3 ºC. No se presentó asociación estadística entre la D.I.A. y el T.A.D.I.A. (p = 0,27), así como tampoco entre las distintas redosificaciones (p = 0,091)

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Livres sur le sujet "Intravenous Ketamine"

Harper, David G. Ketamine : A unique intravenous anaesthetic agent : a review of the literature. [Toronto : Faculty of Dentistry, University of Toronto], 1991.

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Absalom, Anthony, et John Sear. Intravenous anaesthetics. Sous la direction de Michel M. R. F. Struys. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0015.

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In recent decades, increasing attention has been focused on the intravenous anaesthetic agents. This interest has been stimulated by the discovery and availability of agents with increasingly favourable pharmacokinetic and dynamic properties, coupled with advances in knowledge of pharmacology and advances in computer technology. For most patients and operative procedures, anaesthesia is induced with a bolus or fast infusion of a short-acting drug, most commonly propofol. Increasingly, anaesthesia is thereafter also maintained with an infusion of an agent with favourable kinetics, again usually of propofol, commonly supplemented with boluses or infusions of opioids. Propofol is also commonly used for procedural and intensive care sedation. It has highly favourable pharmacokinetics and pharmacodynamics for these applications as sedative or hypnotic agent—rapid, smooth onset, minimal accumulation, and rapid smooth offset of effect—but is by no means an ideal agent. In some specific situations, such as when its haemodynamic or respiratory effects are detrimental, use of alternative agents such as ketamine and etomidate are warranted. All the currently available agents have adverse effects, some of which are related to the active compound and some of which are related to the vehicle. Efforts are thus being made to develop new formulations, with fewer adverse effects, and to develop newer and better drugs. In the future we are also likely to see increasing use of older agents, but for newer indications (such as the use of ketamine as an antidepressant).

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Yousefshahi, Fardin, Giuliano Michelagnoli et Juan Francisco Asenjo. Ketamine Use and Opioid-Tolerant Cancer Patients. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190271787.003.0031.

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Pain occurs in up to 70% of cancer patients and it can be challenging to manage. The standard for analgesic therapy is the World Health Organization ladder; however, up to 25% of patients don’t reach a level of comfort using this approach. Ketamine has been recognized as an excellent adjuvant for cancer pain treatment, especially when other analgesics have failed. Some randomized clinical trials have confirmed ketamine’s efficacy in refractory cancer pain, but most had small sample sizes and low power. Some publications have confirmed the beneficial effect of oral, intranasal, subcutaneous, or intravenous ketamine in treatment of refractory chronic cancer pain, while others are less conclusive. While ketamine is rapidly gaining ground as an adjuvant in treating pain in patients with cancers refractory to conventional therapy and/or patients with opioid tolerance, care should be taken to identify patients with ketamine contraindications in order to offer the greatest benefit with the lowest risk of side effects.

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Sampson, Brett G., et Andrew D. Bersten. Therapeutic approach to bronchospasm and asthma. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0111.

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The optimal management of bronchospasm and acute asthma is reliant upon confirmation of the diagnosis of asthma, detection of life-threatening complications, recognition of β‎2 agonist toxicity, and exclusion of important asthma mimics (such as vocal cord dysfunction and left ventricular failure). β‎2 agonists, anticholinergics, and corticosteroids are the mainstay of treatment. β‎2 agonists should be preferentially administered by metered dose inhaler via a spacer, and corticosteroids by the oral route, reserving nebulized (and intravenous) salbutamol, as well as intravenous hydrocortisone, for situations when these routes are not possible. A single intravenous dose of magnesium may be of benefit in severe asthma, but repeat dosing is likely to cause serious side effects. Parenteral administration of adrenaline may prevent the need for intubation in the patient in extremis. Aminophylline has an unfavourable side effect profile and has not been shown to offer additional benefit in adults. However, it does have a role in paediatric asthma. Unproven medical therapies with potential benefit include ketamine, heliox, inhalational anaesthetics, and leukotriene antagonists. The need for ventilatory support is usually preceded by worsening dynamic hyperinflation, exhaustion, hypoxia, reduced conscious state, or a combination of these. While non-invasive ventilation may have a temporizing role to allow time for response to medical therapy, there is insufficient evidence for its use, and should not delay invasive ventilation. If invasive ventilation is indicated, a strategy of hypoventilation and permissive hypercapnoea, minimizes barotrauma and dynamic hyperinflation. Extracorporeal support may have a role as a rescue therapy.

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Kim, Chang-Yeon, Charles Chang, Raysa Cabrejo et James Yue. Lumbosacral Pain. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190626761.003.0009.

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This chapter examines the options for managing pain after orthopedic spinal surgery in the lumbosacral spine. It reviews the pain syndromes associated with different approaches to the lumbar spine. The chapter explores specific pain syndromes such as failed back syndrome while noting that the majority of pain after spinal surgery results from dissection of soft tissue and muscles. The chapter then discusses oral and parenteral methods for analgesia, as well as spinal and regional nerve blockade. It provides details on the common regimens for pain management including the use of opioids, nonsteroidal anti-inflammatory drugs, gabapentin, acetaminophen, ketamine, and patient-controlled analgesia (both classical intravenous and transdermal iterations). The chapter also notes the use of multimodal analgesic regimens to promote pain control while reducing the risk of opioid-related adverse effects.

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Patel, Mayur B., et Pratik P. Pandharipande. Analgesics in critical illness. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0043.

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Analgesia is a critical component of intensive care unit (ICU) care. Accordingly, understanding the mechanism, physiological consequences, and assessment of pain is important when caring for the ICU patient. Non-pharmacological approaches should be attempted before supplementing analgesia with pharmacological agents. Pharmacologically-based therapies are divided into regional and systemic therapies. Regional analgesic therapies target specific areas of the body while limiting the systemic effects of intravenous analgesics, but at the risk of invasiveness, local anaesthetic toxicity, and infection of in-dwelling catheters. Systemic analgesic therapy is comprised of two main categories—non-opioids and opioids. Typically, non-opioid analgesics are used as adjunctive therapies and consist of agents such as non-steroidal anti-inflammatory drugs, gabapentinoids, ketamine, or α‎2 agonists. Opioid analgesia in the ICU is commonly infusion-based using fentanyl, hydromorphone, morphine, or recently, remifentanil.

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Chapitres de livres sur le sujet "Intravenous Ketamine"

Chen, Mu-Hong, et Tung-Ping Su. « Effects of Adjunctive Ketamine Intravenous Infusion in Taiwanese Patients with Treatment-Resistant Depression : Antidepression, Antisuicidality, BDNF Val66Met, and Brain Imaging ». Dans Ketamine, 175–89. Singapore : Springer Singapore, 2020. http://dx.doi.org/10.1007/978-981-15-2902-3_11.

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Roback, Mark G. « Clinical Effects and Applications of Ketamine ». Dans Total Intravenous Anesthesia and Target Controlled Infusions, 245–65. Cham : Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-47609-4_14.

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Raeder, Johan. « Ketamine, Revival of a Versatile Intravenous Anaesthetic ». Dans Advances in Modelling and Clinical Application of Intravenous Anaesthesia, 269–77. Boston, MA : Springer US, 2003. http://dx.doi.org/10.1007/978-1-4419-9192-8_24.

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Sundaram, Subbulakshmi, et Ashok Swaminathan Govindarajan. « Ketamine for Non-Neuropathic Pain ». Dans Ketamine Revisited - New Insights into NMDA Inhibitors [Working Title]. IntechOpen, 2021. http://dx.doi.org/10.5772/intechopen.101665.

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Chronic pain is one of the leading causes of years lost to disability, as most of the time it is refractory to conventional treatment. Recent advances in understanding the pain mechanisms have favored the use of ketamine as a rescue agent in refractory chronic pain conditions, as it has potential modulating effect on both sensory-discriminative and affective motivational components of pain. Preclinical studies also suggested the antinociceptive effect of sub anesthetic dose of ketamine against central and peripheral neuropathic pain conditions and non-neuropathic pain conditions such as inflammatory and nociceptive pain states. Subanesthetic infusion of ketamine along with adjuvants such as midazolam and clonidine is found to reduce the psychomimetic and cardiovascular side effects of ketamine. Even though the consensus guidelines for intravenous use of ketamine for chronic pain advocate the use of ketamine only for complex regional pain syndrome, various other clinical studies suggested its role in other refractory painful conditions. Hence the present topic focuses specifically on the effect of ketamine on non-neuropathic pain conditions such as complex regional pain syndrome, fibromyalgia, headache, ischemic limb pain, etc. Many studies had shown that ketamine not only reduces the pain scores but also the analgesic medications, which further improves the well-being and quality of life.

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Haleem, Shahla. « Ketamine for Anesthetic Premedication in Children : Pearls, Pitfalls and Review of Clinical Utility ». Dans Ketamine Revisited - New Insights into NMDA Inhibitors. IntechOpen, 2022. http://dx.doi.org/10.5772/intechopen.101354.

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Ketamine, since its difficult introduction into clinical practice nearly half a millennium ago, has now become widely utilized as an anesthetic agent, especially in adults. Its efficacy in procedural anesthesia and pain management, along with its safety, has been proven in several clinical studies. This book chapter reviews the clinical utility of ketamine when used in young individuals. Premedication is an essential component of anesthetic protocol for parents and children to overcome emotional or psychological distress. Preoperative anxiety, being associated with greater pain during postoperative recovery in children, calls for the effective use of premedicants. This chapter describes how the cognizance of perioperative pain and the use of ketamine in children has become especially popular over the past few decades. It also discusses how intramuscular ketamine as a premedicant in subanaesthetic doses has a special role in the management of highly uncooperative children. As a potent analgesic, ketamine has a complex mechanism of action, producing a state of sedation, immobility, analgesia, amnesia, and dissociation from the environment. Some institutions are using ketamine in infants over 7 months and toddlers as part of premedication protocols for preoperative sedation, prevention of response to separation and intravenous access, and postoperative pain control in infants. This chapter also discusses the pearls and pitfalls in using ketamine in these challenging populations.

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Sacks, Sandra, et Ambereen K. Mehta. « Ketamine as an Analgesic Adjuvant in Palliative Care ». Dans Pain, 97–104. Oxford University Press, 2022. http://dx.doi.org/10.1093/med/9780197542873.003.0012.

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Ketamine is an analgesic and anesthetic that inhibits N-methyl-D-aspartate (NMDA) receptors and can be used for cancer-related pain, especially neuropathic pain, and depression. It can be delivered in oral, intranasal, topical, and intravenous forms, and the latter is the most well-studied and most effective. Practitioners should be aware of side effects, especially tachycardia, hypertension, increased intracranial pressure, hallucinations, and delirium. It can help with decreasing the amount of opioids necessary for pain control, and a one-time bolus may help with depression symptoms for weeks after. There are consensus guidelines to guide safe use, dosing, and monitoring.

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Burger, Rebecca K., et Shobhit Jain. « Oral Medications ». Dans The Pediatric Procedural Sedation Handbook, sous la direction de Cheryl K. Gooden, Lia H. Lowrie et Benjamin F. Jackson, 329–36. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190659110.003.0051.

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Midazolam, the most commonly used oral sedative in children, is used primarily as a premedication but can also be beneficial in brief, minimally invasive procedures, with few side effects. Ketamine can be used for brief, painful procedures but can cause vomiting. Dexmedetomidine can be used as a premedication but has not been extensively studied. Chloral hydrate is useful for imaging studies and noninvasive procedures but is limited by its prolonged sedative effects. Melatonin can be used for sedation and anxiolysis for imaging and noninvasive testing, but there is conflicting literature about its analgesic effects. There are limited studies on the use of meperidine and hydroxyzine for dental procedures. Ketamine and dexmedetomidine intravenous preparations have been administered enterally. Melatonin and clonidine are enteral medications that may prove useful in pediatric procedural sedation. In general, enteral administration is associated with preprocedural anxiolysis, uneven bioavailability, and unpredictable onset of action and recovery times.

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Scherrer, Patricia, et Laura Bredbenner. « Voiding Cystourethrography ». Dans The Pediatric Procedural Sedation Handbook, sous la direction de Cheryl K. Gooden, Lia H. Lowrie et Benjamin F. Jackson, 236–40. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190659110.003.0036.

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The voiding cystourethrogram (VCUG), which involves bladder catheterization and then fluoroscopic imaging of bladder filling and voiding, is the “gold standard” procedure for the diagnosis of vesicoureteral reflux in children. However, it can be associated with significant distress and discomfort for children. Child Life Specialists are essential to preprocedure preparation and coping strategies for all children, but some patients may also require procedural sedation. Oral or intranasal midazolam and nitrous oxide are the two most commonly used agents, each with its own advantages. Some children may benefit from even deeper levels of sedation, including dissociative sedation/analgesia with oral or intravenous ketamine, deep sedation with intravenous propofol, or even general anesthesia with inhaled anesthetics such as sevoflurane. The choice of regimen should be a joint decision among the multidisciplinary team members to best meet the needs of the child.

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Iyalomhe, G. B. S., et S. I. Iyalomhe. « Efficacy and Safety of Intravenous Ketamine Anaesthesia in a Suburban Nigerian Hospital ». Dans New Horizons in Medicine and Medical Research Vol. 8, 108–13. Book Publisher International (a part of SCIENCEDOMAIN International), 2022. http://dx.doi.org/10.9734/bpi/nhmmr/v8/2206b.

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Portal, Benjamin, Ravneet Bhullar et Charles Argoff. « Nerve Blocks and Drug Infusions ». Dans Neuropathic Pain, sous la direction de Nadine Attal et Didier Bouhassira, 239—C40P14. Oxford University PressNew York, 2023. http://dx.doi.org/10.1093/med/9780197616345.003.0040.

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Abstract This chapter presents the case of a patient with complex regional pain syndrome (CRPS) who had difficulty undergoing physiotherapy due to pain. For this patient, regional somatic nerve blocks using local anesthetics may be proposed because they may have at least short-term benefit and facilitate physiotherapy. They may also be useful for diagnostic purposes. Sympathetic nerve blocks are routinely used for CRPS, but evidence based on adequate studies is lacking. Infusion techniques for neuropathic pain include intravenous infusions of ketamine or lidocaine, which may be beneficial for a short period and may be envisaged after concertation to relieve severe pain exacerbations for patients with refractory neuropathic pain.

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Actes de conférences sur le sujet "Intravenous Ketamine"

Kavyashree, M., Nagashiva Karthik Bhandaru, Prasad Kulkarni et A. V. Pai. « A Comparative Study of Etomidate and Ketamine Hydrochloride for Intravenous Induction of General Anaesthesia ». Dans ISACON KARNATAKA 2017 33rd Annual Conference of Indian Society of Anaesthesiologists (ISA), Karnataka State Chapter. Indian Society of Anaesthesiologists (ISA), 2017. http://dx.doi.org/10.18311/isacon-karnataka/2017/fp008.

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Sartori, V., E. Zanderigo, M. Kvasnica et M. Morari. « Optimal infusion policy of intravenous morphine and ketamine - A Mixed-Integer Linear Programming application ». Dans 2005 IEEE Engineering in Medicine and Biology 27th Annual Conference. IEEE, 2005. http://dx.doi.org/10.1109/iembs.2005.1616941.

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« PS-127 - INTERVENCIÓN EN REDUCCIÓN DE RIESGOS Y DAÑOS EN PRÁCTICA DE SLAMMING EN CONTEXTO DE CHEMSEX ». Dans 24 CONGRESO DE LA SOCIEDAD ESPAÑOLA DE PATOLOGÍA DUAL. SEPD, 2022. http://dx.doi.org/10.17579/abstractbooksepd2022.ps127.

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INTRODUCCIÓN: En contexto de Chemsex, la práctica del Slamming se refiere al uso inyectado de drogas solubles, especialmente mefedrona y metanfetamina, ketamina y otras. Los riesgos asociados se relacionan con el tipo de drogas y la técnica de inyección, a saber: enfermedades infecciosas con alto riesgo de transmisión sanguínea al compartir material de inyección, lesiones derivadas de la inyección (flebitis, abcesos). OBJETIVOS: Planteamos el caso de un paciente, atendido en las consultas de patología dual, por consumo de mefedrona en contexto de chemsex. Es el propio paciente quien solicita al equipo de salud mental la intervención de reducción de riesgos y daños en la administración intravenosa de mefedrona, la cual realizaba de forma muy errática. El objetivo principal en el caso presentado es introducir técnicas correctas de inyección de drogas intravenosas (lugar de inyección, dosis, kit de materiales) a un paciente con práctica activa de slamming a fin de reducir riesgos y daños. Y como objetivos secundarios introducir prácticas seguras antes y después de cada sesión de inyección. MATERIALES Y MÉTODOS: Se ha realizado una revisión sistemática de la literatura científica en lo relacionado a la reducción de riesgos en trastornos por uso de sustancias, en concreto del chemsex y el uso de drogas por vía intravenosa; a través de Pubmed y Google scholar, primordialmente. RESULTADOS Y CONCLUSIONES: Se plantea la reducción de riesgos y daños mediante la intervención del equipo de salud mental. Sesión de nociones anatómicas que faciliten localizar y canalizar las venas, presentación de kit de materiales, enseñanza de técnicas de inyección correcta, disminuyendo los daños colaterales de la práctica sexual. Principalmente, nuestra intervención minimizaría las complicaciones asociadas y derivadas de la técnica mal realizada, disminuyendo así la dosis de sustancias administradas y generando un vínculo de ayuda y apoyo al paciente.

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Nunes, Thainá Galvão, Renan Souto Terra, Thales Cateano Provinciali et João Augusto Dugim Neto. « OBSTRUÇÃO URETRAL E AZOTEMIA EM FELINO : RELATO DE CASO ». Dans I Congresso On-line Nacional de Clínica Veterinária de Pequenos Animais. Revista Multidisciplinar em Saúde, 2021. http://dx.doi.org/10.51161/rems/1912.

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Introdução: A obstrução uretral em felinos é um sinal clínico comum da doença do trato urinário inferior da espécie, no qual quando associada a outras alterações, geralmente o animal apresenta um quadro de disúria ou anúria, podendo evoluir a óbito. Objetivos: Relatar um caso de obstrução uretral em um felino macho, destacando a importância do rápido manejo de desobstrução e suporte terapêutico para reversão de quadro da azotemia intensa. Material e métodos: Um felino macho, sem raça definida, 3 anos, castrado, foi atendido na clínica veterinária “Provet Soluções Veterinárias” com inapetência, prostração, hipertermia, desidratação, mucosas hipocoradas e vesícula urinária repleta na palpação abdominal. Na anamnese foi relatado como principais queixa: apatia, anorexia, disúria há cerca de dois dias, sendo indicativo de um quadro de obstrução uretral. Foi realizado o hemograma completo e perfil bioquímico com dosagem de ureia e creatinina, observando-se intensa leucocitose, neutrofilia e monocitose absoluta, aumento nos valores da ureia e creatinina: 650 mg/dL e 13,1 mg/dL, respectivamente. O animfal foi sedado com Xilazina 2% associado à Ketamina 2 mg/kg e realizado o processo de desobstrução uretral com sonda uretral tipo Tom Cat (sem mandril). O animal foi submetido a lavagem vesical BID com 40 ml de soro fisiológico, fluidoterapia intravenosa com cloreto de sódio à 0,9% e administração por via subcutânea de dexametasona (0,5 mg/animal/SID) e enrofloxacina (5mg/kg/SID). No quarto dia de internação, a urina se apresentava de forma límpida, clara e sem sinais de infecção. Resultados: Um novo exame bioquímico foi realizado, no qual foi constado a normalização nos níveis séricos de ureia e creatinina. O animal recebeu alta médica com prescrição de enrofloxacina por via oral (5mg/kg/SID) por 3 dias, ração urinary por 60 dias e Pró-Rim Homeopático Veterinário, sendo administrado uma borrifada diretamente na mucosa oral, por 30 dias. Conclusão: Pode-se confirmar, a partir do caso relatado, o sucesso terapêutico da fluidoterapia associado ao processo de desobstrução e sondagem por até três dias para a correção dos efeitos da uremia e evitar possível recidiva, evitando dessa forma uma afecção adversa dos rins e uma possível patologia renal.

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Rapports d'organisations sur le sujet "Intravenous Ketamine"

Acred, Aleksander, Milena Devineni et Lindsey Blake. Opioid Free Anesthesia to Prevent Post Operative Nausea/Vomiting. University of Tennessee Health Science Center, juillet 2021. http://dx.doi.org/10.21007/con.dnp.2021.0006.

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Purpose The purpose of this study is to compare the incidence of post-operative nausea and vomiting (PONV) in opioid-utilizing and opioid-free general anesthesia. Background PONV is an extremely common, potentially dangerous side effect of general anesthesia. PONV is caused by a collection of anesthetic and surgical interventions. Current practice to prevent PONV is to use 1-2 antiemetics during surgery, identify high risk patients and utilize tracheal intubation over laryngeal airways when indicated. Current research suggests minimizing the use of volatile anesthetics and opioids can reduce the incidence of PONV, but this does not reflect current practice. Methods In this scoping review, the MeSH search terms used to collect data were “anesthesia”, “postoperative nausea and vomiting”, “morbidity”, “retrospective studies”, “anesthesia, general”, “analgesics, opioid”, “pain postoperative”, “pain management” and “anesthesia, intravenous”. The Discovery Search engine, AccessMedicine and UpToDate were the search engines used to research this data. Filters were applied to these searches to ensure all the literature was peer-reviewed, full-text and preferably from academic journals. Results Opioid free anesthesia was found to decrease PONV by 69%. PONV incidence was overwhelming decreased with opioid free anesthesia in every study that was reviewed. Implications The future direction of opioid-free anesthesia and PONV prevention are broad topics to discuss, due to the nature of anesthesia. Administration of TIVA, esmolol and ketamine, as well as the decision to withhold opioids, are solely up to the anesthesia provider’s discretion. Increasing research and education in the importance of opioid-free anesthesia to decrease the incidence of PONV will be necessary to ensure anesthesia providers choose this protocol in their practice.

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