Efficacy Of Low-dose Ketamine Research Articles

Comparison of Low Dose Ketamine Versus Normal Saline in Prevention of Postoperative Shivering

Background: Shaking is a frequent adverse effect of anesthesia, which may potentially exacerbate the discomfort. It is characterized by involuntary muscular contractions that can affect many muscle groups. It is extremely unpleasant and physically demanding. Objective: The purpose of this study is to examine the efficacy of Low Dose Ketamine against normal saline in preventing postoperative trembling. Study Design: Randomized Controlled Trial. Setting: Department of Anesthesiology, Khyber Teaching Hospital, Peshawar. Duration of Study: This study was conducted from 1st July 2020 to 31st December 2020. Subjects and Methods: Sixty male and female patients who volunteered for lower abdominal surgery were studied. Each block of six was shuffled before the randomization procedure began. Thirty people made up the Low Dose Ketamine group (A), and the Normal Saline group (B) (B). After 30 minutes, the Crossley and Mahajan scale was used to measure the degree to which both groups were shivering after the surgical incisions had healed. This was done so that we could gauge the accuracy of the measuring device. Results: Age range in this study was from 20 to 60 years. Efficacy was observed in 28 (93.3%) patients in group A as compare to 16 (53.3%) patients in group B (P= 0.000). Conclusion: As a consequence of this research, it appears that 0.25 mg/kg of ketamine is an effective dose for minimizing postoperative shivering after elective surgery. Keywords: Postoperative shivering, Low dose ketamine, Efficacy

Perioperative Low-Dose Ketamine for Postoperative Pain Management in Spine Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Objective Although low-dose ketamine has been shown to be generally beneficial in terms of pain control in a variety of major surgery, there is no consensus regarding the effectiveness of supplemental ketamine analgesic use exclusively in spine surgery. The objective of this systematic review and meta-analysis of randomized controlled trials (RCTs) was to assess the efficacy and safety of perioperative low-dose ketamine for pain management and analgesic consumption in patients undergoing spine surgery. Methods A comprehensive literature search was performed for relevant studies using PubMed, EMBASE, Web of Science, and Cochrane Library. Patients who received perioperative low-dose ketamine were compared to the control group in terms of postoperative pain intensity, opioid consumption, and adverse events. Patients were further categorized by ages and administration times for subgroup analysis. Results A total of 30 RCTs comprising 1,865 patients undergoing elective spine surgery were included. Significantly lower pain intensity and less opioid consumption at 12 h, 24 h, and 48 h postoperatively and lower incidence of postoperative nausea and vomiting (PONV) were observed in the ketamine group (all P < 0.05). There was no significant difference of central nervous system (CNS) adverse events between groups. However, different efficacy of low-dose ketamine was detected when patients were categorized by ages and administration times. Conclusion Perioperative low-dose ketamine demonstrated analgesic and morphine-sparing effect with no increased adverse events after spine surgery. However, this effect was not significant in pediatric patients. Only postoperative or intraoperative and postoperative administration could prolong the analgesic time up to 48 h postoperatively. Further studies should focus on the optimal protocol of ketamine administration and its effect on old age participants.

Pre-emptive Analgesic Efficacy of Low Dose Ketamine versus Magnesium Sulfate in Patients Undergoing Major Abdominal Surgeries Under General Anaesthesia: A Randomised Clinical Study

Introduction: Pre-emptive analgesia has been proposed to result in better pain management, reduced analgesic consumption, and improved patient satisfaction. Aim: To evaluate pre-emptive analgesic efficacy of intravenous ketamine and intravenous magnesium sulfate in patients undergoing major abdominal surgeries under general anaesthesia by administering it 10 min before the incision. Materials and Methods: This randomised, double-blind, clinical study, was conducted in JLN Medical College, Ajmer, Rajasthan, India, from November 2019 to November 2020. The study included 100 patients, aged 18-60 years of American Society of Anesthesiologists (ASA) physical status I and II were randomly allocated into two groups. Group K (n=50) received intravenous (i.v.) ketamine infusion 0.3 mg/ kg in 100 mL normal saline over 10 minutes. Group M (n=50) received i.v. magnesium sulfate (mgso4) infusion 30 mg/ kg in 100 mL normal saline over 10 minutes. The duration of analgesia, total amount of rescue analgesic consumed in 24 hours, haemodynamics, and side-effects were noted. The quantitative data was presented as mean±standard deviation and were compared by student’s t-test. Results: Duration of analgesia was significantly prolonged in group K (67.96±9.20 min) as compared to group M (30.60±6.44 min) (p-value&lt;0.001). The total dose of rescue analgesic consumption in 24 hours was lesser in group K (1180±388.09) as compared to group M (1280±453.56) (p-value=0.236). Haemodynamics and side-effect profile were comparable in the two groups. Conclusion: In major abdominal surgeries under general anaesthesia, patients getting ketamine have longer duration of analgesia compare to magnesium sulfate, have an improved quality of recovery after surgery and less serious adverse events in the Postanesthesia Care Unit (PACU). Ketamine reduces the need for intraoperative opioids and could suppress the pressure response to endotracheal intubation.

Comparative safety and efficacy of low dose ketamine and opioids for acute pain management at the emergency department

Background: Pain is a complex phenomenon for which many pharmacological agents have been discovered and utilized for pain relief. Ketamine is a more preferred pain reliever over opioids in the emergency department (ED). The aim of this study was to compare the safety and efficacy of low dose ketamine (LDK) with morphine (opioid) for pain relief among patients presenting to the ED.&#x0D; Methodology: A prospective, cohort study was conducted over a sample of 280 patients presented with acute pain to the ED, Ziauddin University Hospital, Karachi. These patients were then divided into two groups via simple random sampling with randomization being assured using an online randomizer software tool. The 1st group (n=140) was given 0.2 mg/kg of LDK while 0.1 mg/kg of intravenous morphine (opioid) was given to the 2nd group (n=140). The pain intensity was measured using the Visual Analogue Scale (VAS) from admission to 60 mins, the records were taken after every 15 mins. The adverse events (AE’s) were also recorded for both groups. The data was then analyzed using SPSS Version 21 &amp; Microsoft Excel 2016.&#x0D; Results: Out of 280 patients enrolled in the study, there was male majority i.e. 76.07% while the remaining were females with the mean age of 29±7 years. Within 15 minutes of initial dose administration in both groups, a marked reduction in pain intensity was observed. Reduced respiratory rate, pruritus and decreased O2 saturation were common AE’s observed, which were comparatively higher among patients receiving morphine as compared to ketamine.&#x0D; Conclusion: The efficacy of morphine (opium) and LDK is similar in alleviating pain in an emergency setting, however, LDK is visibly safer than its opioid counterpart and thus may be used as a safer alternative.

Comparative safety and efficacy of low dose ketamine and opioids for acute pain management at the emergency department.

Comparative safety and efficacy of low dose ketamine and opioids for acute pain management at the emergency department.

To Evaluate the Efficacy of Low Dose Ketamine in Attenuating Haemodynamic Stress Response Induced by Pneumoperitoneum in Laparoscopic Cholecystectomy Under General Anaesthesia: A Prospective Study

To Evaluate the Efficacy of Low Dose Ketamine in Attenuating Haemodynamic Stress Response Induced by Pneumoperitoneum in Laparoscopic Cholecystectomy Under General Anaesthesia: A Prospective Study

Efficacy of Low-dose Ketamine as Sole Analgesic Agent in Maintaining Analgesia and Intraoperative Hemodynamics During Laparoscopic Gynecological Surgeries.

Background:Ketamine, in low doses, is known to possess intense analgesic properties. The available literature shows wide variation regarding the time and dose of administration of ketamine during surgery.Aim:The aim of this study was to evaluate the effect of intraoperative administration of ketamine when used as sole analgesic in low doses, on hemodynamics and postoperative analgesia in patients undergoing laparoscopic gynecological surgery and compared on the basis of duration of surgery.Settings and Design:This prospective, observational study was conducted from July to December 2015, over a period of 6 months in a tertiary care medical college and hospital.Materials and Methods:Seventy patients between 23 and 55 years planned for laparoscopic gynecological surgery were recruited. Ketamine was given in a dose of 0.5 mg/kg preoperatively and then repeated every ½ hourly in a dose of 0.25 mg/kg throughout the surgery. Hemodynamic parameters, time to the first rescue analgesia and complications were recorded for the first 8 h. Statistical evaluation was done and result expressed as percentage. Paired t-test was employed for the comparison of numerical variables within the group.Results:Seventy percent of the patients did not require any postoperative rescue analgesia during the first 8 h after surgery. None of the patients complained of pain immediately after extubation, and 16% of the patients had minor postoperative complications. The intraoperative hemodynamic profile was significantly altered. Duration of surgery and dose of ketamine required did not affect the duration of analgesia.Conclusion:Ketamine in low dose proved to be an efficacious analgesic even in the long duration laparoscopic gynecological surgeries. It stabilizes intraoperative hemodynamics thereby reducing the requirement of other anesthetic and antihypertensive agents.

146 Safety and Efficacy of Low-dose Ketamine Added to a Hydromorphone Titration Protocol for Emergency Department Patients With Acute Severe Pain

146 Safety and Efficacy of Low-dose Ketamine Added to a Hydromorphone Titration Protocol for Emergency Department Patients With Acute Severe Pain

Room 301, 10/18/2000 2: 00 PM - 3: 30 PM (PD) The Efficacy of Low-Dose Ketamine in Addition to Postoperative Patient-Controlled Analgesia

<b>Room 301, 10/18/2000 2: 00 PM - 3: 30 PM (PD) The Efficacy of Low-Dose Ketamine in Addition to Postoperative Patient-Controlled Analgesia</b>