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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ketamine 4 micrograms/kg/minute produced pain relief similar to that from morphine 33 micrograms/minute in a double-blind study that compared analgesia from constant-rate intravenous infusions of the two drugs in 60 patients. The analgesic efficacy of the infusions, as assessed by pain scores and the requirement for supplementary self-administered morphine, was poor. Ventilatory depression, the most significant side effect, occurred only in patients who received morphine infusion. The low dose ketamine infusion did not provide clinically useful analgesia even though adequate plasma concentrations were achieved.
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PMID:Analgesia from morphine and ketamine. A comparison of infusions of morphine and ketamine for postoperative analgesia. 331 43

The prevention of postoperative pain in children who had undergone tonsillectomy was investigated in a double-blind trial. Ketamine (Ketalar; Parke-Davis) 0.5 mg/kg was given intravenously before the operation to 20 children and saline to a control group of 20 children. Premedication consisted of oral trimeprazine 4 mg/kg given 2 hours pre-operatively. The anaesthetic technique was standardised. There were no significant differences between the groups pre-or intra-operatively. Postoperatively there were significant differences in the measurement of pain but not in that of sedation. No hallucinations were encountered in those receiving ketamine. It is concluded that analgesic doses of ketamine are safe and effective.
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PMID:Prevention of post-tonsillectomy pain with analgesic doses of ketamine. 332 83

Voluntary abortions in day hospitals fulfill the need for shorter hospital stays and minimal interference with patient activities; on the other hand, it makes it more difficult to evaluate the possible complications of anesthesia. 1820 patients who received general anesthesia for voluntary abortion were given a questionnaire before they were discharged; items queried included drowsiness, headache, dizziness, nausea or vomiting, sore throat or mouth, abdominal cramps, pain at IV site, backache or muscular cramps, inability to perform daily activities. Only 465 patients returned the questionnaire. The most frequent complaint was sleepiness or drowsiness (19.8%), headache (7.1%), dizziness (15.1%), nausea or vomiting (8.2%), abdominal cramps (24.7%), and backache (16.7%). There seems to be less nausea or vomiting with the use of pentothal rather than alothane. Ketamine was never used on its own. The findings seen to suggest that the simplest combinations of drugs result in fewer and less severe complications than the use of several drugs.
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PMID:[Minor sequelae of ambulatory anesthesia]. 345 85

Thirty-four patients of ASA physical status I or II scheduled for gall bladder surgery were studied in a comparative prospective trial to evaluate the efficacy of epidural and intramuscular ketamine for postoperative pain relief. They were divided randomly into three groups. Group I (11 patients) received 30 mg intramuscular ketamine. Group II (10 patients) and Group III (13 patients) received 10 and 30 mg ketamine in 10 ml saline respectively, through epidural catheters. Pain was evaluated every two hours for the first 24 hours post-operatively by using a linear analogue pain scale from 0-10. Ketamine was given on the patient's request and whenever the pain score exceeded three. Ketamine produced analgesia in all patients studied. The reduction of pain score after two and four hours in Group I and III was significant when compared to Group II. Seven patients (54 per cent) in Group III did not require further analgesia after the initial injection. However, following 10 mg epidural ketamine or 30 mg IM ketamine, post-operative pain was more frequent. Four patients who received epidural ketamine complained of transient burning pain in the back during injection. No patient developed respiratory depression, psychic disturbance, cardiovascular instability, bladder dysfunction or neurologic deficit. It is concluded that 30 mg epidural ketamine is a safe and effective method for postoperative analgesia.
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PMID:Epidural ketamine for postoperative analgesia. 394 42

A study was made of ketamine hydrochloride's effectiveness in decreasing viseral pain in 50 patients undergoing postpartum abdominal tubal ligation, a procedure involving visceral pain but not requiring muscular relaxation. Patients were pre-medicated and ketamine was administered (10 mg/ml intravenously) until the patient no longer responded to surgical stimulae. The majority of patients (39) required 1 mg/kg of ketamine for induction and repeated doses of 20 mg each, every 5 minutes, for maintenance (31 patients). Analgesic effectiveness was judged on the following basis: Good - no movement or phonation during surgery (74 percent); Fair - slight limb movement or occasional phonation (20 percent); Poor - gross movement or loud phonation (6 percent). On the average blood pressure rose 14 percent, heart rate 21 percent, and respiratory rate 34 percent. Some dizziness was experienced by all patients. Alveolar-arterial oxygen difference was increased in several cases; possibly due to increase in right-to-left pulmonary blood shunt. Ketamine was found to be an adequate anaesthetic in 94% of patients with administered doses well below recommended amounts.
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PMID:The use of ketamine for abdominal tubal ligation. 473 98

30 postoperative patients, who had undergone abdominal gynaecological surgery with standard general anaesthesia were randomly divided into three groups and received, in the recovery ward, a continuous infusion of either pentazocine, piritramid, or ketamine. The patients rated their pain on a 15 cm pain analogue score. Group I pentazocine: Mean dosage on the day of operation 0.12 mg/kg/h, 0.1 mg/kg/h on the first and only 0.07 mg/kg/h on the second postoperative day. Pentazocine blood levels were on average 50 micrograms/l. Group II piritramid: Mean dosage on the day of operation 0.038 mg/kg/h, 0.024 mg/kg/h on the first and 0.019 mg/kg/h on the second postoperative day. Blood levels of piritramid were not determined because there is no satisfactory assay available. Group III ketamine: mean dosage on the day of operation 0.32 mg/kg/h, 0.28 mg/kg/h on the first and 0.29 mg/kg/h on the second postoperative day. Ketamine blood levels lay between 120 and 180 micrograms/l. The three analgesics did not cause any important haemodynamic or respiratory side effects. Pentazocine and piritramid were the most effective analgesics, ketamine was the least effective with a high incidence of side effects.
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PMID:[Clinical experimental studies of postoperative infusion analgesia]. 641 86

Thirty postoperative patients, after undergoing abdominal hysterectomy and standard general anesthesia, were randomly allocated to three groups and received, in the recovery ward, a continuous infusion of either pentazocine, piritramide, or ketamine. The patients rated their pain on a 15-cm visual analog scale. Patients in group 1 received pentazocine. Mean dosage was 0.12 mg/kg/hr on the day of operation, 0.1 mg/kg/hr on the first postoperative day, and only 0.07 mg/kg/hr on the second postoperative day. Pentazocine blood levels averaged 50 micrograms/L. Patients in group 2 received piritramide. Mean dosage was 0.038 mg/kg/hr on the day of operation, 0.024 mg/kg/hr on the first postoperative day, and 0.019 mg/kg/hr on the second postoperative day. Blood levels of piritramide were not determined because no satisfactory assay is available. Patients in group 3 received ketamine. Mean dosage was 0.32 mg/kg/hr on the day of operation, 0.28 mg/kg/hr on the first postoperative day, and 0.29 mg/kg/hr on the second postoperative day. Ketamine blood levels ranged between 120 and 180 micrograms/L. None of the three analgesics caused any important hemodynamic or respiratory side effects. Pentazocine and piritramide were more effective analgesics than ketamine was. Ketamine also had a higher incidence of side effects.
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PMID:Clinical experimental studies of postoperative infusion analgesia. 662 85

Ketamine, a cataleptic analgesic substance which theoretically may block pain receptors in the spinal cord, providing pain relief without respiratory depression, was injected intrathecally with or without benzethonium chloride 0.1 mg/ml (a preservative) into 8 monkeys under anaesthesia. Two monkeys received saline (control group). No assessment as to relief from experimental pain was possible. All Monkeys recovered normally from anaesthesia and were found moving about in their enclosures without gross evidence of neurological impairment. No adverse reactions were noted. Ten days after the subarachnoid injection the monkeys are sacrificed. Autopsy was performed within 30 minutes. No macroscopic abnormality of the cord was noticed. Microscopic examination revealed oedema of a few nerve roots in all animals, irrespective of whether ketamine or saline was injected intrathecally. Focal degeneration with loss of myelin and axoplasm was observed within a solitary nerve root in 2 monkeys that had received ketamine, 1 with and 1 without preservative. However, in these animals lumbar puncture proved difficult and bloody taps ensued. Hence trauma could have been a contributing factor in these 2 cases. None of the other monkeys showed these changes, regardless of group.
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PMID:Effects of intrathecal saline and ketamine with and without preservative on the spinal nerve roots of monkeys. 689 51

Ketamine, an analgesic-cataleptic drug, provides pain relief without respiratory depression. Ketamine with the preservative benzethonium chloride 0.1 mg/ml was injected intrathecally into 4 baboons under Ketamine anaesthesia. A control group of 2 baboons received intrathecal saline. No assessment as to relief from experimental pain was possible, but all the baboons recovered normally from anaesthesia and were found moving about in their enclosures without gross evidence of neurological impairment. No adverse reactions were noted. One month after the intrathecal injection the baboons were sacrificed, and an autopsy was performed within 30 minutes. No macroscopic abnormally of the cord was noticed. Microscopic examination revealed oedema of a few nerve roots in all animals irrespective of whether ketamine or saline had been injected intrathecally. No other changes attributable to ketamine were seen, and its is therefore concluded that, in the doses given, intrathecally injected ketamine would seem to be safe.
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PMID:Intrathecal ketamine with preservative - histological effects on spinal nerve roots of baboons. 689 52

The neurophysiologic mechanism of ketamine-induced analgesia was studied in cats under conditions of electrolytic decerebration or pentobarbital anesthesia. Injection of bradykinin into the femoral artery served as the noxious stimulus and the neural response in the lateral funiculus of the spinal cord was recorded by the multi-unit activity technique. Ketamine depressed the bradykinin-induced response more markedly in decerebrate, non-anesthetized cats than in pentobarbital-anesthetized cats. The depressant action disappeared following cervical cord transection at C1, in both decerebrate non-anesthetized and pentobarbital-anesthetized cats. Thus the analgesic action of ketamine is probably exerted mainly through activation of the supraspinal pain inhibition system and a direct action on the spinal cord nociceptive neural mechanism, if any, is slight. The excitatory action of ketamine on the supraspinal pain inhibition system is susceptible to the depressant action of pentobarbital.
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PMID:Activation of the supraspinal pain inhibition system by ketamine hydrochloride. 731 84


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