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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Based on experiences from anaesthesia of approximately 7000 cats in a four year period the effects of a combination of 20--25 mg/kg Ketamine and 0.5 mg/kg Xylazine given i/m are described. In the present study the Xylazine has been applied in considerably lower doses, compared with previous reports on these drugs, and this change has reduced the unwanted side effects, without at the same time reducing the effect on the muscular tension and the psychical disturbances induced by the Ketamine. Ketamine and Xylazine were given in one injection after being taken in the named sequence and mixed in the syringe. Indication for anaesthetizing the cats were, besides routine surgery in the out-patient clinic, operations of weakened animals for pyometra, foreign bodies, intestinal invaginations with and without resection, removal of abdominal tumors and urolithiasis. Animals with impared liver function were not anaesthetized with these drugs due to the important role of liver metabolism in their excretion. In spite of the fact that the corneal and laryngeal reflexes normally persist, the combination of the two drugs allowed surgery in these organs after application of local anaesthetics as an extra precaution. Premedication with atropine has not been used routinely, and still only very few cases of increased salivation or vomiting have been observed. Aspiration has not been a complication and in the whole material, only 3 deaths have occurred, none of them with a specific post mortem finding besides shock. In these 3 cases the patient died later than 45 minutes after the injection and after ended surgery. Side effects ascribed to phenomena of interaction have not been observed. One cat was anaesthetized a number of times during pregnancy without any effect on the cat or its kittens. It is concluded, that the Ketamine/Xylazine combination, when mixed as prescribed gives a very safe and pleasant narcosis, and that side effects are minimized, if the corneas are moistened with an ophthalmic ointment and the patient is allowed to recover in dark and quiet surroundings.
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PMID:[Clinical use of ketamine-xylazine for anaesthesia in the cat (author's transl)]. 46 Nov 18

Thiopentone 4 mg/kg, Althesin 0.055 ml/kg and ketamine 2 mg/kg were compared in 157 children undergoing minor otolaryngological surgery, mostly adenotonsillectomy. Premedication was with pethidine and atropine and anaesthesia was maintained with nitrous oxide in oxygen and halothane. Tracheal intubation was facilitated with suxamethonium. In each group half of the children received pethidine 0.7 mg/kg after intubation and the remainder received saline. Ketamine increased arterial pressure after induction. The cardiovascular responses to intubation were more obvious after thiopentone and Althesin than after ketamine. Operating conditions, cardiovascular changes during operation and the course of extubation were similar in all groups. The recovery after ketamine was longer than after thiopentone and Althesin. Thiopentone was associated with significantly less vomiting immediately after operation than was Althesin and ketamine. In the period immediately after operation Althesin was associated with a higher need for analgesics compared with thiopentone and ketamine. Pethidine prolonged the recovery after thiopentone, decreased the incidence of vomiting immediately after operation associated with Althesin and increased that associated with ketamine.
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PMID:Comparison of thiopentone, Althesin and ketamine in anaesthesia for otolaryngological surgery in children. 88 50

This study was undertaken to determine the dosages, treatment times and side effects of ketamine HCI with and without two benzodiazepines when used for sedation on a group of precooperative children at the UCLA Children's Dental Center. Ketamine was evaluated when used alone, and in conjunction with two benzodiazepines, diazepam or a new water-soluble midazolam. An anti-muscarinic, atropine or glycopyrrolate, and nitrous oxide-oxygen were included in all sedations. Mean treatment times were increased significantly when ketamine and a benzodiazepine were used in combination. Additionally, mean ketamine dosages were decreased significantly when ketamine was utilized in combination with a benzodiazepine. All children tolerated the sedation well and there were no severe adverse reactions. Side effects included nausea, vomiting, and a rise in post-operative temperatures.
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PMID:Clinical evaluation of the effects of ketamine sedation on pediatric dental patients. 152 83

A clinico-statistical survey was carried out on dental treatment for children under general anesthesia who visited the clinic of Pedodontic Department, Matsumoto Dental College Hospital during the period of 1986 to 1989. The number of cases subjected in this survey was 108 (57 boys 51 girls), aged from one year and 5 months to 8 years and 9 months. All of these patients were admitted to the hospital for 3 days and were treated under general anesthesia, using GOE in 107 cases (in 80 cases by nasal intubation, in 27 cases by oral intubation). One case was administrated by intravenous anesthesia with Ketamine. The results were as follows: 1. The patient ages of the patients ranged from one year 5 months to 8 years 9 months. 2. Thirteen percent of the patients were handicapped. Fifty three percent of the patients had to visit hospitals in remote areas. 3. The number of restored teeth per patient was 15 on the average. The teeth were treated with composite resin filling in 8.5 teeth, composite resin crown in 2.6 teeth, metal crown 3.6 teeth and other material in 0.8 (extraction). 4. Pulpal treatment was carried out on 42 percent of the subjected teeth. 5. The average anesthesia administration time was 3 hours and 28 minutes. No serious trouble was observed although minor complications were seen post-operatively such as high fever or vomiting in some cases.
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PMID:[Dental treatment for children under general anesthesia]. 215 75

Emergency physicians frequently perform painful but necessary procedures on frightened children. We conducted a prospective, uncontrolled clinical trial of ketamine sedation (4 mg/kg IM) to facilitate a variety of procedures in 108 children aged 14 months to 13 years. Acceptable conditions were achieved with a single injection in 97% of the patients, and adjunctive restraint or local anesthesia was not required in 86%. Full sedation was produced within five minutes in 83%. Mean duration from injection to dischargeable recovery was 82 minutes (range, 30 to 175 minutes). One 18-month-old child vomited shortly after injection and experienced transient laryngospasm with cyanosis; intubation was not required, and there were no adverse sequelae. Airway patency and independent respirations were fully maintained in all other patients; no hemodynamic instability occurred at any time. There were no other clinically significant complications. Emesis well into the recovery phase was noted in 6% of the patients. Nightmares were not observed. Response from parents and physicians was strongly positive. Ketamine can be effectively used by emergency physicians to facilitate procedural sedation, yet equipment and expertise for advanced airway management are mandatory due to the rare occurrence of laryngospasm.
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PMID:Ketamine sedation for pediatric procedures: Part 1, A prospective series. 203 20

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

Ketamine was administered to 47 women aged 14-41 years who were about to undergo induced abortions. The patients received 2.5 mg of lorazepam 2 hours before the operation and 7.5 mg/kg of ketamine diluted in orange juice or water 45 minutes before. In all cases, sleep and transfer to the operating table were accomplished in calm and semidarkness. Intravenous tubes were inserted and .02 mg/kg of atropine sulfate was administered. Patients considered still conscious were given intravenous injections of ketamine 1 mg/kg. Perioperative evaluation of the quality of anesthesia was done using a 4-level scale based on reactions to stimuli. Ketamine .5 mg/kg was administered intravenously each time significant reactions were obtained. 45 minutes after oral ketamine administration, 8 patients were still conscious and received additional anesthesia. 9 of the 39 patients asleep at the preoperative evaluation required additional anesthesia during the procedure. The immediate postoperative period was calm in all cases, even though some patients later reported having had disagreeable hallucinations. 46.8% had vomiting. The frequency of vomiting declined from 54.4% to 28.8% when pure water was substituted for orange juice as the vector for the preoperative oral ketamine. Correct responses to simple questions were obtained an average of 12.4 minutes postoperatively, but all patients had periods of somnolence lasting 4.8 hours on average. 15 had partial recollections of the surgery. 78.8% of the patients stated that the anesthesia used was excellent or good. 8.5% felt it was average, and 10.6% felt it was poor. Very few publications mention oral use of ketamine. The failure rates of 17% during the preoperative evaluation and 23% during the operation were not negligible and were probably due to the very low bioavailability of ketamine administered orally and the variability of digestive absorption of ketamine from 1 subject to another. The method appears to be appropriate for use in induced abortions, but better management is required to reduce failure rates and control side effects of vomiting and disagreeable postoperative hallucinations.
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PMID:[Anesthesia with oral ketamine]. 362 Oct 17

The behaviour of 48 children ranging from weeks to eight years was observed and compared after four different anaesthesia methods. Either ethrane or halothane was used with or without induction with ketamine i.m. (5 mg/kg bodyweight). Restlessness, the depth of postanaesthetic sleep, shivering, muscle rigidity and vomiting were evaluated every 15 min. up to one hour postoperatively using a graduation from 1--4. Ketamine combined with halothane showed significantly less postoperative restlessness than all other methods. No statistically proven differences were seen in the other criteria, which were noticed more than once. The psychic effects as well as the practical clinical application of this method are discussed.
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PMID:[Steal-induction with ketamine in childhood: comparison of the postanaesthetic period (author's transl)]. 746 56

The potency of S-(+)-ketamine is approximately double that of the racemic ketamine. This study was carried out to investigate the recovery of cerebral electrical function after a bolus of 1.3 mg/kg ketamine or 0.65 mg/kg S-(+)-ketamine and subsequent continuous application of 4 mg/kg h ketamine per h or 2 mg/kg S-(+)-ketamine, per h for 15 min. Furthermore, the centrally acting, cholinergic agonist physostigmine has been reported to antagonize ketamine and to shorten the recovery period. Therefore, after S-(+)-ketamine 0.012 mg/kg physostigmine was tested against saline placebo. METHODS. With their own informed consent and the approval of the ethics committee 12 healthy volunteers were enrolled in a double-blind cross-over study. All drugs were dissolved in identical volumes. On three dates with intervals of at least 1 week between, ketamine/NaCl, S-(+)-ketamine/physostigmine or S-(+)-ketamine/NaCl was administered (Table 1). The sequence was randomized. The EEG was recorded from 20 sites according to the 10/20 system and after Fast-Fourier transformation computed into amplitudes within the delta, theta, alpha, and beta bands and within the total spectrum. The median, the spectral edge frequency and the dominant frequency (dF) were also determined. Mean values of all electrodes before and at 10, 15, 30, 45 and 195 min after the bolus injection were compared using two-dimensional analysis of variance (ANOVA, significance level P < 0.05). RESULTS. The characteristic increase in theta-amplitude and decrease of alpha-amplitude were observed after ketamine and S-(+)-ketamine. Median and dF dropped from the alpha to the theta frequency range. Ketamine led to a greater increase in total, delta, theta and beta amplitude during anaesthesia. 3 hours after ketamine/S-(+)-ketamine anaesthesia a significant decrease in the median and dominant frequency and in total, delta, theta, alpha and beta amplitudes confirmed residual impairment of cerebral function after all study drugs. No differences were found between physostigmine and placebo. DISCUSSION. The EEG changes during ketamine/S-(+)-ketamine administration suggest a slightly deeper anaesthetic level after ketamine. The course of recovery was not different after ketamine and after S-(+)-ketamine. The spectral edge frequency did not differ between measurement points, and is therefore not suitable for assessment of the depth of anaesthesia reached with ketamine/S-(+)-ketamine. The dose of physostigmine tested was probably too low to produce antagonism of S-(+)-ketamine. An increased dosage of physostigmine has yet to be studied, but is likely to cause a higher rate of side effects, such as nausea, vomiting and bradycardia, and possibly even tonic-clonic seizures.
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PMID:[Ketamine racemate versus S-(+)-ketamine with or without antagonism with physostigmine. A quantitative EEG study on volunteers]. 784 Apr 18

Ketamine (K) is a good analgesic and anesthetic agent in short procedures, but the associated cardiovascular responses and emergence reactions limit its use. Benzodiazepines have been used to improve recovery with favourable reports for midazolam (M). Methylphenidate (MPH), the mild CNS stimulant, improves behaviour and mental concentration and can be used to improve recovery from K anesthesia. This was tested, alone and in combination with M by a double-blind study in 30 patients subjected to short transurethral urologic procedures. Patients were randomized into 3 equal groups to receive K-MPH, K-M or K-M-MPH. M (7.5 mg) was mixed with K and MPH (20 mg) was given at the end of urologic procedures. Perioperative monitoring included pulse rate, blood pressure, ECG, and plasma catecholamines. Recovery was assessed by a triad VAS and recovery area was calculated. Distribution-free statistics were used to assess intergroup differences of similar variables. Ketamine produced satisfactory anesthesia for short transurethral urologic procedures. Addition of M did not change the cardiovascular responses of K but resulted in smooth recovery with no changes in the recovery scores. MPH did not improve the recovery scores but increased the incidence of vomiting, excessive talking, and limb movements.
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PMID:Ketamine anesthesia for short transurethral urologic procedures. 841 56


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