Safety and efficacy of dexmedetomidine vs ketamine vs midazolam combined with propofol in gastrointestinal endoscopy for cancer patients

Safety and efficacy of dexmedetomidine vs ketamine vs midazolam combined with propofol in gastrointestinal endoscopy for cancer patients

In cancer patients who underwent GI endoscopy, dexmedetomidine-propofol and ketamine-propofol had better sedation efficacy [lower achievement time of RSS 3–4, total propofol dose, and eye-opening time] compared to midazolam-propofol... read more

The Ketamine Drive-Through

The Ketamine Drive-Through

Patients who present with unexplained urinary tract symptoms or laboratory abnormalities on tests for liver injury should be asked about exposure to ketamine. Patients who chronically use ketamine should also be screened... read more

Acute Effects of Ketamine on ICP in Children With Severe TBI

Acute Effects of Ketamine on ICP in Children With Severe TBI

In this retrospective, exploratory study, intracranial pressure (ICP) did not increase following ketamine administration. In the setting of a guidelines-based protocol, ketamine was associated with a reduction in ICP during... read more

Fear and Insight in the ICU Bed

Fear and Insight in the ICU Bed

Mid-morning dressing changes, hours wasted, going through each cut methodically. Dressing off, wound cleaned, redressed. The brunt of pain dealt with by nature before giving in. The intensive care unit (ICU) nurse offers... read more

Why Are We Still Talking about ICP and Ketamine?

Why Are We Still Talking about ICP and Ketamine?

A trauma patient required emergent intubation during a recent shift. The altered patient was suspected of having an intracranial bleed. My resident was concerned about rapid onset of hypoxia and other internal injuries causing... read more

The Reemergence of Ketamine for Treatment in Critically Ill Adults

The Reemergence of Ketamine for Treatment in Critically Ill Adults

Ketamine has suggested potential benefit in several disease states impacting critically ill patients including pain, alcohol withdrawal syndrome, status epilepticus, and acute agitation. Further supporting evidence is needed... read more

Ketamine vs. Nonketamine Regimens for Analgosedation in the ICU

Ketamine vs. Nonketamine Regimens for Analgosedation in the ICU

Results suggest ketamine as an adjunct analgosedative has the potential to reduce opioid exposure in postoperative and MV patients in the ICU. More RCTs are required before recommending routine use of ketamine in select populations. A... read more

Etomidate vs. Ketamine for Emergency Endotracheal Intubation

Etomidate vs. Ketamine for Emergency Endotracheal Intubation

While the primary outcome of Day 7 survival was greater in patients randomized to ketamine, there was no significant difference in survival by Day 28. A prospective, randomized, open-label, parallel assignment, single-center... read more

Consensus Guidelines on the Use of Intravenous Ketamine Infusions for Acute Pain Management

Consensus Guidelines on the Use of Intravenous Ketamine Infusions for Acute Pain Management

Evidence supports the use of ketamine for acute pain in a variety of contexts, including as a stand-alone treatment, as an adjunct to opioids, and, to a lesser extent, as an intranasal formulation. Contraindications for... read more

Midazolam and Ketamine Produce Neural Changes in Memory and Pain

Midazolam and Ketamine Produce Neural Changes in Memory and Pain

Painful stimulation during light sedation with midazolam, but not ketamine, can be accompanied by increased coherence in brain connectivity, even though details are less likely to be recollected as explicit memories. In... read more

Ketamine: A Review of an Established Yet Often Underappreciated Medication

Ketamine: A Review of an Established Yet Often Underappreciated Medication

has proven to be a complex medication with unusual properties, heterogeneous, interconnected mechanisms, and diverse, sometimes contested, clinical uses. Ketamine's story begins in 1956 when scientists identified a new... read more

Ketamine for Treatment-Resistant Depression

Ketamine for Treatment-Resistant Depression

This book brings together an international group of clinicians and researchers from a broad swath of inter-related disciplines to offer the most up-to-date information about clinical and preclinical research into ketamine... read more

Study Finds Lower Dose of Ketamine Equally Effective in Reducing Pain

Study Finds Lower Dose of Ketamine Equally Effective in Reducing Pain

Ketamine is known to provide pain relief comparable to opioid medications, which are highly addictive. In the recent study, appearing in the journal Academic Emergency Medicine, researchers studied 98 patients, ages 18 to... read more

Perspectives of Ketamine Use in COVID-19 Patients

Perspectives of Ketamine Use in COVID-19 Patients

Hospitalized coronavirus disease 2019 (COVID-19)-infected patients suffer from both physical impairments and mental stress. Respiratory insufficiency and cardiovascular disturbances require most of the intensive care... read more