Linked Life Data

16115991

Source:http://linkedlifedata.com/resource/pubmed/id/16115991

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
3
pubmed:dateCreated
2005-8-23
pubmed:abstractText
N-methyl-D-aspartate (NMDA) receptor antagonists enhance opioid-induced analgesia. The plasma concentration of ketamine, an NMDA receptor antagonist that enhances epidural morphine-and-bupivacaine-induced analgesia, is not known. We examined 24 patients with lung carcinoma or metastatic lung tumor who underwent video-assisted thoracic surgery in a placebo-controlled, double-blind manner 4 h after emergence from anesthesia. The morphine + ketamine group (n = 8) and morphine + placebo group (n = 8) received 5 mL volume of 2.5 mg morphine and 0.25% bupivacaine and the placebo + ketamine group (n = 8) received 5 mL volume of saline and 0.25% bupivacaine epidurally at the end of skin closure. Four hours after this anesthesia, in the morphine + ketamine and placebo + ketamine groups, ketamine was administered to successively maintain a stable plasma ketamine concentration of 0, 10, 20, 30, 40, and 50 ng/mL by a target-controlled infusion device, and patients assessed the levels of pain at rest, pain on coughing, somnolence (drowsiness), and nausea using a 100-mm visual analog scale (VAS). In the morphine + placebo group, a placebo (saline) was similarly administered instead of ketamine. In the morphine + ketamine group, the VAS scores for pain at rest and pain on coughing significantly decreased on ketamine administration at a plasma concentration of 20 ng/mL or larger compared with the respective baseline VAS scores (P < 0.05 each). In the placebo + ketamine group, the VAS scores for pain at rest and pain on coughing did not significantly change at any plasma concentration of ketamine as compared to the morphine + placebo group. In the morphine + ketamine group, a plasma concentration of ketamine larger than 20 ng/mL did not further reduce VAS scores for pain at rest and pain on coughing. The VAS scores for drowsiness were comparable among the three groups at any plasma concentration of ketamine. Ketamine at a plasma concentration of 20 ng/mL or larger may enhance epidural morphine-and-bupivacaine-induced analgesia. As an adjunct with epidural morphine-and-bupivacaine and considering the safety of small doses, the minimal plasma concentration of ketamine given IV may be approximately 20 ng/mL.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Sep
pubmed:issn
0003-2999
pubmed:author
pubmed:issnType
Print
pubmed:volume
101
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
777-84
pubmed:dateRevised
2006-11-15
pubmed:meshHeading
pubmed-meshheading:16115991-Adult, pubmed-meshheading:16115991-Aged, pubmed-meshheading:16115991-Analgesics, Opioid, pubmed-meshheading:16115991-Anesthesia, Epidural, pubmed-meshheading:16115991-Anesthetics, Dissociative, pubmed-meshheading:16115991-Anesthetics, Local, pubmed-meshheading:16115991-Bupivacaine, pubmed-meshheading:16115991-Cough, pubmed-meshheading:16115991-Dose-Response Relationship, Drug, pubmed-meshheading:16115991-Double-Blind Method, pubmed-meshheading:16115991-Drug Synergism, pubmed-meshheading:16115991-Female, pubmed-meshheading:16115991-Humans, pubmed-meshheading:16115991-Ketamine, pubmed-meshheading:16115991-Male, pubmed-meshheading:16115991-Middle Aged, pubmed-meshheading:16115991-Morphine, pubmed-meshheading:16115991-Pain, pubmed-meshheading:16115991-Pain Measurement, pubmed-meshheading:16115991-Thoracic Surgery, Video-Assisted
pubmed:year
2005
pubmed:articleTitle
Determining the plasma concentration of ketamine that enhances epidural bupivacaine-and-morphine-induced analgesia.
pubmed:affiliation
Department of Anesthesiology, Second Hospital Nippon Medical School, Kanagawa 211-8533, Japan. manzo@nms.ac.jp
pubmed:publicationType
Journal Article, Clinical Trial, Randomized Controlled Trial, Research Support, Non-U.S. Gov't