Journal of clinical anesthesia
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Randomized Controlled Trial Comparative Study
Is magnesium sulfate effective for pain in chronic postherpetic neuralgia patients comparing with ketamine infusion therapy?
Postherpetic neuralgia (PHN) is a frequent debilitating complication and one of the most intractable pain disorders, particularly in elderly patients. Although tricyclic antidepressants, topical capsaicin, gabapentin, and oxycodone are effective for alleviating PHN, many patients remain refractory to current therapies. Here, the analgesic effects of ketamine or magnesium for PHN were assessed in an open prospective study. ⋯ Ketamine and magnesium showed significant analgesic effects in patients with PHN.
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Randomized Controlled Trial Comparative Study
Addition of low-dose ketamine to midazolam-fentanyl-propofol-based sedation for colonoscopy: a randomized, double-blind, controlled trial.
To evaluate the effects of low-dose ketamine on midazolam-fentanyl-propofol-based sedation for outpatient colonoscopy. ⋯ Addition of low-dose ketamine to midazolam-fentanyl-propofol-based sedation for outpatient colonoscopy resulted in more rapid and better quality of sedation, less propofol consumption, more stable hemodynamic status, and less adverse effects with similar recovery times in adult patients.
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Randomized Controlled Trial
Evaluation of the effect of ketamine on remifentanil-induced hyperalgesia: a double-blind, randomized study.
Opioids are associated with hyperalgesia that can reduce their analgesic effect. The aim of this study was to determine whether the addition of ketamine reduces remifentanil-induced hyperalgesia; improves its analgesic effect; and alters interleukin 6 (IL-6), IL-8, and IL-10 levels. ⋯ It was not possible to demonstrate that the addition of ketamine (5 μg/kg per minute) is effective in preventing or reducing remifentanil-induced postoperative hyperalgesia in laparoscopic cholecystectomy.
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In most instances, delayed emergence from anesthesia is attributed to residual anesthetic or analgesic medications. However, delayed emergence can be secondary to unusual causes and present diagnostic dilemmas. ⋯ In this review, we summarize and discuss less common and difficult to diagnose reasons for delayed emergence and present cases from our own experience or reference published case reports/case series. The goal is to draw attention to less common reasons for delayed emergence, identify patient populations that are potentially at risk and to help anesthesiologists identifying a possible cause why their patient is slow to wake up.
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The study objective is to investigate the effects of a simple price list sticker placed on vaporizers on anesthetic use and costs. The price list only showed the cost per hour of the annually most expensive drugs, which had a low-cost alternative. ⋯ Price sticker on vaporizers may be an effective, simple, and cheap method to reduce anesthetic costs.