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1.
Ulus Travma Acil Cerrahi Derg ; 30(5): 309-315, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38738674

RESUMO

BACKGROUND: This study aimed to evaluate the histopathological and biochemical effects of ketamine on penile tissues following ischemia-reperfusion injury induced by priapism. METHODS: Twenty-four male rats were randomized into three groups. Group 1 served as the control group. Group 2 underwent the priapism model to induce ischemia-reperfusion injury. Group 3, the treatment group, experienced a similar ischemia-reperfusion model as Group 2; additionally, 50 mg/kg of ketamine was administered intraperitoneally just before reperfusion. Blood biochemical analyses and penile histopathological evaluations were performed. RESULTS: In Group 3, significant improvements were observed in all histopathological scores, including desquamation, edema, inflammation, and vasocongestion compared to Group 2 (p<0.001). Blood biochemical analyses showed that the malondialdehyde (MDA) levels were recorded as 10 in Group 2, with a significant decrease in Group 3 (p=0.013). Similarly, proinflammatory cytokine levels, including interleukin-1 beta (IL-1ß), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α), were found to be suppressed in Group 3 compared to Group 2 (p=0.003, p=0.022, and p=0.028, respectively). Antioxidant enzyme activities, such as glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD), were higher in Group 3 compared to Group 2 (p=0.016 and p=0.024, respec-tively). CONCLUSION: Ketamine is an effective anesthetic agent in alleviating the effects of penile ischemia-reperfusion injury.


Assuntos
Modelos Animais de Doenças , Ketamina , Malondialdeído , Pênis , Priapismo , Traumatismo por Reperfusão , Animais , Ketamina/administração & dosagem , Ketamina/farmacologia , Ketamina/uso terapêutico , Masculino , Priapismo/tratamento farmacológico , Priapismo/etiologia , Ratos , Pênis/efeitos dos fármacos , Pênis/irrigação sanguínea , Pênis/patologia , Traumatismo por Reperfusão/tratamento farmacológico , Traumatismo por Reperfusão/metabolismo , Malondialdeído/metabolismo , Fator de Necrose Tumoral alfa/sangue , Fator de Necrose Tumoral alfa/metabolismo , Distribuição Aleatória , Anestésicos Dissociativos/administração & dosagem , Interleucina-1beta/metabolismo , Interleucina-1beta/sangue
2.
BMC Health Serv Res ; 24(1): 598, 2024 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-38715038

RESUMO

BACKGROUND: Access to anaesthesia and surgical care is a major problem for people living in Sub-Saharan Africa. In this region, ketamine is critical for the provision of anaesthesia care. However, efforts to control ketamine internationally as a controlled substance may significantly impact its accessibility. This research therefore aims to estimate the importance of ketamine for anaesthesia and surgical care in Sub-Saharan Africa and assess the potential impact on access to ketamine if it were to be scheduled. METHODS: This research is a mixed-methods study, comprising of a cross-sectional survey at the hospital level in Rwanda, and key informant interviews with experts on anaesthesia care in Sub-Saharan Africa. Data on availability of four anaesthetic agents were collected from hospitals (n = 54) in Rwanda. Semi-structured interviews with 10 key informants were conducted, collecting information on the importance of ketamine, the potential impact of scheduling ketamine internationally, and opinions on misuse of ketamine. Interviews were transcribed verbatim and analysed using a thematic analysis approach. RESULTS: The survey conducted in Rwanda found that availability of ketamine and propofol was comparable at around 80%, while thiopental and inhalational agents were available at only about half of the hospitals. Significant barriers impeding access to anaesthesia care were identified, including a general lack of attention given to the specialty by governments, a shortage of anaesthesiologists and migration of trained anaesthesiologists, and a scarcity of medicines and equipment. Ketamine was described as critical for the provision of anaesthesia care as a consequence of these barriers. Misuse of ketamine was not believed to be an issue by the informants. CONCLUSION: Ketamine is critical for the provision of anaesthesia care in Sub-Saharan Africa, and its scheduling would have a significantly negative impact on its availability for anaesthesia care.


Assuntos
Ketamina , Humanos , Estudos Transversais , Ruanda , Entrevistas como Assunto , Anestesia/métodos , Acessibilidade aos Serviços de Saúde , Anestésicos Dissociativos/administração & dosagem , Substâncias Controladas , África Subsaariana , Pesquisa Qualitativa
3.
Neurosci Biobehav Rev ; 162: 105693, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38697379

RESUMO

Music and ketamine are both known to affect therapeutic outcomes, but few studies have investigated their co-administration. This scoping review describes the existing literature on the joint use of music and ketamine-or esketamine (the S(+) enantiomer of ketamine)-in humans. The review considers that extant studies have explored the intersection of ketamine/esketamine and music in healthy volunteers and in patients of various age groups, at different dosages, through different treatment processes, and have varied the sequence of playing music relative to ketamine/esketamine administration. Studies investigating the use of music during ketamine anesthesia are also included in the review because anesthesia and sedation were the early drivers of ketamine use. Studies pertaining to recreational ketamine use were omitted. The review was limited to articles published in the English language but not restricted by publication year. To the best of our knowledge, this scoping review is the first comprehensive exploration of the interplay between music and ketamine/esketamine and offers valuable insights to researchers interested in designing future studies.


Assuntos
Ketamina , Música , Ketamina/administração & dosagem , Ketamina/farmacologia , Humanos , Musicoterapia , Anestésicos Dissociativos/administração & dosagem , Anestésicos Dissociativos/farmacologia
4.
Am J Emerg Med ; 81: 10-15, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38626643

RESUMO

INTRODUCTION: Patients exhibiting signs of hyperactive delirium with severe agitation (HDSA) may require sedating medications for stabilization and safe transport to the hospital. Determining the patient's weight and calculating the correct weight-based dose may be challenging in an emergency. A fixed dose ketamine protocol is an alternative to the traditional weight-based administration, which may also reduce dosing errors. The objective of this study was to evaluate the frequency and characteristics of adverse events following pre-hospital ketamine administration for HDSA. METHODS: Emergency Medical Services (EMS) records from four agencies were searched for prehospital ketamine administration. Cases were included if a 250 mg dose of ketamine was administered on standing order to an adult patient for clinical signs consistent with HDSA. Protocols allowed for a second 250 mg dose of ketamine if the first dose was not effective. Both the 250 mg initial dose and the total prehospital dose were analyzed for weight based dosing and adverse events. RESULTS: Review of 132 cases revealed 60 cases that met inclusion criteria. Patients' median weight was 80 kg (range: 50-176 kg). No patients were intubated by EMS, one only requiring suction, three required respiratory support via bag valve mask (BVM). Six (10%) patients were intubated in the emergency department (ED) including the three (5%) supported by EMS via BVM, three (5%) others who were sedated further in the ED prior to requiring intubation. All six patients who were intubated were discharged from the hospital with a Cerebral Performance Category (CPC) 1 score. The weight-based dosing equivalent for the 250 mg initial dose (OR: 2.62, CI: 0.67-10.22) and the total prehospital dose, inclusive of the 12 patients that were administered a second dose, (OR: 0.74, CI: 0.27, 2.03), were not associated with the need for intubation. CONCLUSION: The 250 mg fixed dose of ketamine was not >5 mg/kg weight-based dose equivalent for all patients in this study. Although a second 250 mg dose of ketamine was permitted under standing orders, only 12 (20%) of the patients were administered a second dose, none experienced an adverse event. This indicates that the 250 mg initial dose was effective for 80% of the patients. Four patients with prehospital adverse events likely related to the administration of ketamine were found. One required suction, three (5%) requiring BVM respiratory support by EMS were subsequently intubated upon arrival in the ED. All 60 patients were discharged from the hospital alive. Further research is needed to determine an optimal single administration dose for ketamine in patients exhibiting signs of HDSA, if employing a standardized fixed dose medication protocol streamlines administration, and if the fixed dose medication reduces the occurrence of dosage errors.


Assuntos
Delírio , Serviços Médicos de Emergência , Ketamina , Agitação Psicomotora , Humanos , Ketamina/administração & dosagem , Ketamina/uso terapêutico , Delírio/tratamento farmacológico , Serviços Médicos de Emergência/métodos , Masculino , Feminino , Pessoa de Meia-Idade , Agitação Psicomotora/tratamento farmacológico , Idoso , Adulto , Estudos Retrospectivos , Idoso de 80 Anos ou mais , Anestésicos Dissociativos/administração & dosagem , Anestésicos Dissociativos/uso terapêutico , Peso Corporal
5.
Emerg Med Pract ; 26(5): 1-24, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38639638

RESUMO

Ketamine has been in use since its development as a dissociative anesthetic in the 1960s, but it was largely confined to the operating theater or austere environments until used by emergency physicians to facilitate painful procedures in children. As the unique effects of ketamine across its dose-response curve were understood, new applications emerged. In low doses, ketamine has found an important role alongside or instead of opioids in the management of severe pain, and methods to slow its absorption allow higher, more effective doses while attenuating psychoperceptual effects. Ketamine's unique anesthetic properties have inspired its use as an induction agent for intubation without a paralytic and for the rapid, safe control of dangerously agitated patients. Emerging uses for ketamine in acute care include treatment for status epilepticus and alcohol withdrawal syndrome; however, its most important rising indication may be as an emergency treatment of depression and suicidality.


Assuntos
Alcoolismo , Ketamina , Síndrome de Abstinência a Substâncias , Criança , Humanos , Ketamina/uso terapêutico , Ketamina/farmacologia , Síndrome de Abstinência a Substâncias/tratamento farmacológico , Anestésicos Dissociativos/uso terapêutico , Dor/tratamento farmacológico , Serviço Hospitalar de Emergência
6.
J Zoo Wildl Med ; 55(1): 200-206, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38453503

RESUMO

The maned sloth (Bradypus torquatus) is an endemic and endangered species of two Brazilian states, with much unknown biological information needed to direct conservation actions. Other sloth species have been studied regarding anesthesia; however, there is a lack of anesthesia research for the maned sloth. Anesthetic data were collected from 12 free-range maned sloths that were immobilized for a field examination. Individuals were anesthetized using a combination of ketamine (4.0 mg/kg) and medetomidine (0.03 mg/kg), and antagonized with atipamezole (0.1 mg/kg). Time to induction and recovery were recorded and compared with sex and age classes. After the induction and until antagonist administration, physiological parameters (rectal temperature, heart rate, respiratory rate, and oxygen saturation) were recorded every 10 min during anesthesia and were statistically evaluated over time. Induction was fast (3.21 ± 0.76), but recovery was longer (113.3 ± 18) when compared to other studies. Induction and recovery times were not different across sex or age classes. Rectal temperature, heart rate, and oxygen saturation remained stable throughout the procedure. Respiratory rate significantly decreased over time, from 18.25 ± 7.03 to 13.17 ± 3.66 movements per minute. Our results indicate that the described combination of ketamine and medetomidine is a safe and effective choice for anesthesia of maned sloths.


Assuntos
Anestésicos , Ketamina , Bichos-Preguiça , Humanos , Animais , Medetomidina/farmacologia , Ketamina/farmacologia , Bichos-Preguiça/fisiologia , Animais Selvagens/fisiologia , Anestésicos/farmacologia , Imobilização/veterinária , Imobilização/métodos , Hipnóticos e Sedativos/farmacologia , Frequência Cardíaca , Anestésicos Dissociativos/farmacologia
7.
Emerg Med Australas ; 36(3): 443-449, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38379190

RESUMO

OBJECTIVE: To compare the efficacy and safety of ketamine alone with those of ketamine-dexmedetomidine combination for sedation during brain CT in paediatric patients with head injuries. METHODS: We retrospectively analysed the data of paediatric patients who underwent sedation for brain CT at the ED. We included patients aged 6 months to 6 years with American Society of Anesthesiologists physical status I or II. The sedative protocol involved the administration of intramuscular (IM) ketamine 3 mg/kg (K), ketamine 2 mg/kg with dexmedetomidine 1.5 µg/kg (KD) or ketamine 1.5 mg/kg with dexmedetomidine 1.5 µg/kg (low-KD). The primary and secondary outcomes were sedation failure and adverse events, respectively. RESULTS: We included 77 patients; among them, 28, 23 and 26 were in the K, KD and low-KD groups, respectively. In multivariable analysis, the combination groups (KD and low-KD groups) were significantly associated with a lower possibility of sedation failure compared to the K group (adjusted odds ratio, 0.12; 95% confidence interval, 0.02-0.56). Moreover, there were no significant differences in adverse events between the groups, and the sedation-related time variables also did not significantly differ among the three groups. CONCLUSIONS: Our findings indicated that a combination of IM ketamine-dexmedetomidine provides effective sedation for paediatric patients undergoing brain CT without significant adverse events. Further research is needed to investigate the potential benefits of using lower doses of ketamine in combination.


Assuntos
Dexmedetomidina , Hipnóticos e Sedativos , Ketamina , Tomografia Computadorizada por Raios X , Humanos , Ketamina/administração & dosagem , Ketamina/uso terapêutico , Dexmedetomidina/administração & dosagem , Dexmedetomidina/farmacologia , Estudos Retrospectivos , Masculino , Feminino , Pré-Escolar , Lactente , Hipnóticos e Sedativos/administração & dosagem , Hipnóticos e Sedativos/farmacologia , Criança , Tomografia Computadorizada por Raios X/métodos , Traumatismos Craniocerebrais/diagnóstico por imagem , Sedação Consciente/métodos , Anestésicos Dissociativos/administração & dosagem
8.
Int J Pharm ; 652: 123820, 2024 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-38242258

RESUMO

Animal experimentation is a critical part of the drug development process and pharmaceutical research. General anesthesia is one of the most common procedures. Careful administration and dosing of anesthetics ensure animal safety and study success. However, repeated injections are needed to maintain anesthesia, leading to adverse effects. Ketamine, a dissociative anesthetic, is commonly used for inducing anesthesia in animals and suffers from a short half-life requiring repeated dosing. Herein, we report a novel system for controlled anesthesia post-intraperitoneal administration. A polymer solution called "premix" was developed using two stimuli-responsive polymers, Pluronic (PF) and Carbopol (CP). As the premix was mixed with ketamine solution and injected, it underwent in situ gelation, hence controlling ketamine release and anesthesia. The PF and CP concentrations were optimized for the gelation temperature and viscosity upon mixing with the ketamine solution. The optimal premix/ketamine formulation (1.5:1) was liquid at room temperature and gel at physiological conditions with favorable mucoadhesion and rheology. Premix retarded the release of ketamine, translating to tunable anesthesia in vivo. Anesthesia duration and recovery were tunable per ketamine dose with minimal side effects. Therefore, we propose the implementation of PF/CP premix as a vehicle for general anesthesia in animals for optimal duration and effect.


Assuntos
Ketamina , Animais , Polímeros , Anestesia Geral/métodos , Anestésicos Dissociativos/farmacologia , Poloxâmero
9.
Vet Rec ; 194(1): e3666, 2024 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-37990755

RESUMO

BACKGROUND: Safe chemical immobilisation of wild felids is essential for both conservational management and clinical purposes. However, little is known about drug protocols and current practice. METHODS: This study was designed as an online survey based on a questionnaire. Descriptive/correlation statistics and analysis of proportions were used for data analysis. RESULTS: The preferred immobilisation technique was the use of darts (37% of the respondents), while the most popular drug combination was a mixture of benzodiazepines, alpha-2 adrenoreceptor agonists and dissociative anaesthetics (27%). The inclusion of ketamine in the drug mixture was associated with a quicker anaesthetic onset, as estimated by the participants (p < 0.001). Common complications were prolonged recovery (46%), bradycardia (35%), hypoventilation (32%), hypothermia (26%) and arousal (26%). Commonly encountered problems were inappropriate equipment (39%), lack of suitable drugs (27%) and inadequate knowledge of species-specific pharmacology (29%) and physiology (24%). LIMITATIONS: Incomplete adherence to the Checklist for Reporting Results of Internet E-Surveys is acknowledged. CONCLUSIONS: Drug protocols including both alpha-2 adrenoreceptor agonists and dissociative anaesthetics are preferred in wild felids, and the inclusion of ketamine may be useful to achieve a quick onset. Equipment/drug availability and species-specific knowledge are potential areas of improvement to improve wild felid anaesthesia.


Assuntos
Felidae , Ketamina , Gatos , Animais , Ketamina/uso terapêutico , Ketamina/farmacologia , Anestésicos Dissociativos , Inquéritos e Questionários
10.
J ECT ; 40(2): 134-139, 2024 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-38109337

RESUMO

OBJECTIVE: Electroconvulsive therapy (ECT) is highly effective for severe psychiatric disorders; however, short seizure durations may lead to ineffective therapy. This retrospective study aimed to examine the risks and benefits of switching to ketamine anesthesia to augment seizure durations during an acute course of ECT. METHODS: We included 33 patients who underwent ketamine anesthesia due to suboptimal seizures during an acute course of ECT. We assessed seizure duration, stimulus dose, hemodynamic variability, and postseizure complications before and after switching to ketamine. RESULTS: Age was significantly associated with suboptimal seizures during ECT ( P = 0.040). After switching to ketamine, 32 patients (97%) experienced prolonged seizure duration. Ketamine significantly prolonged both electroencephalogram and motor seizure durations with a mean difference of 34.6 seconds (95% confidence interval [CI], 26.4-42.7 seconds; P < 0.001) and 26.6 seconds (95% CI, 19.6-33.6 seconds; P < 0.001), respectively. It also significantly reduced stimulus dose (mean difference, -209.5 mC [95% CI, -244.9 to -174.1 mC]; P < 0.001). In addition, maximum changes in systolic blood pressure and heart rate during ECT sessions significantly increased with ketamine (mean difference, 27.2 mm Hg [95% CI, 12.0-42.4 mm Hg; P = 0.001]; 25.7 beats per minute [95% CI, 14.5-36.8 beats per minute; P < 0.001], respectively). Patients reported more headaches with ketamine ( P = 0.041). CONCLUSIONS: Our results provide evidence that ketamine as an alternative anesthetic can augment seizure durations in specific patients experiencing suboptimal seizures during an acute course of ECT. However, its use requires greater attention to circulatory management and postseizure complications.


Assuntos
Anestésicos Dissociativos , Eletroconvulsoterapia , Ketamina , Convulsões , Humanos , Ketamina/uso terapêutico , Ketamina/administração & dosagem , Eletroconvulsoterapia/métodos , Masculino , Feminino , Estudos Retrospectivos , Pessoa de Meia-Idade , Convulsões/etiologia , Adulto , Idoso , Eletroencefalografia , Pressão Sanguínea/efeitos dos fármacos , Frequência Cardíaca/efeitos dos fármacos
11.
J Clin Psychopharmacol ; 43(5): 407-410, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37683228

RESUMO

PURPOSE/BACKGROUND: Ketamine is an N -methyl- d -aspartate-antagonistic dissociative anesthetic infused intermittently for off-label management of treatment-resistant depression, acute suicidality, and postpartum depression. Despite the prevalence of postpartum depression nearing upward of 15% of deliveries, almost no research has been done to evaluate its safety during lactation. METHODS: In this study, human milk samples were released from the InfantRisk Center's Human Milk Biorepository of 4 participants treated with intermittent ketamine infusions (49-378 mg) to determine the levels of the drug and its active norketamine metabolite using liquid chromatography-mass spectrometry. RESULTS: The absolute infant dose of ketamine from human milk was 0.003 to 0.017 mg/kg per day, and norketamine was 0.005 to 0.018 mg/kg per day. The relative infant dose (RID) for ketamine ranged from 0.34% to 0.57%. The RID for norketamine ranged from 0.29% to 0.95%. There were no reported infant adverse effects. CONCLUSION: The findings of this study suggest that the transfer of ketamine, as well as its active metabolite, norketamine, into human milk is minimal, as estimated by RIDs less than 1% in all participants. These relative doses are well below standardly accepted safety thresholds.


Assuntos
Depressão Pós-Parto , Ketamina , Feminino , Humanos , Leite Humano , Anestésicos Dissociativos
13.
Neurotoxicology ; 97: 78-88, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37196828

RESUMO

Zebrafish is known for its widespread neurogenesis and regenerative capacity, as well as several biological advantages, which turned it into a relevant animal model in several areas of research, namely in toxicological studies. Ketamine is a well-known anesthetic used both in human as well as veterinary medicine, due to its safety, short duration and unique mode of action. However, ketamine administration is associated with neurotoxic effects and neuronal death, which renders its use on pediatric medicine problematic. Thus, the evaluation of ketamine effects administration at early stages of neurogenesis is of pivotal importance. The 1-41-4 somites stage of zebrafish embryo development corresponds to the beginning of segmentation and formation of neural tube. In this species, as well as in other vertebrates, longitudinal studies are scarce, and the evaluation of ketamine long-term effects in adults is poorly understood. This study aimed to assess the effects of ketamine administration at the 1-4 somites stage, both in subanesthetic and anesthetic concentrations, in brain cellular proliferation, pluripotency and death mechanisms in place during early and adult neurogenesis. For that purpose, embryos at the 1-4 somites stage (10.5 h post fertilization - hpf) were distributed into study groups and exposed for 20 min to ketamine concentrations at 0.2/0.8 mg/mL. Animals were grown until defined check points, namely 50 hpf, 144 hpf and 7 months adults. The assessment of the expression and distribution patterns of proliferating cell nuclear antigen (PCNA), of sex-determining region Y-box 2 (Sox 2), apoptosis-inducing factor (AIF) and microtubule-associated protein 1 light chain 3 (LC3) was performed by Western-blot and immunohistochemistry. The results evidenced the main alterations in 144 hpf larvae, namely in autophagy and in cellular proliferation at the highest concentration of ketamine (0.8 mg/mL). Nonetheless, in adults no significant alterations were seen, pointing to a return to a homeostatic stage. This study allowed clarifying some of the aspects pertaining the longitudinal effects of ketamine administration regarding the CNS capacity to proliferate and activate the appropriate cell death and repair mechanisms leading to homeostasis in zebrafish. Moreover, the results indicate that ketamine administration at 1-4 somites stage in the subanesthetic and anesthetic concentrations despite some transitory detrimental effects at 144 hpf, is long-term safe for CNS, which are newly and promising results in this research field.


Assuntos
Ketamina , Animais , Criança , Humanos , Ketamina/toxicidade , Peixe-Zebra/metabolismo , Anestésicos Dissociativos/toxicidade , Morte Celular , Proliferação de Células , Embrião não Mamífero
17.
J Wildl Dis ; 59(2): 281-287, 2023 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-37036477

RESUMO

A combination of tiletamine-zolazepam, medetomidine, and azaperone was used to immobilize captive Chacoan peccaries (Catagonus wagneri) for health assessments and biological sample collection at the Centro Chaqueño para la Conservación e Investigación (CCCI) in the Paraguayan Chaco during July in 2017 and 2018. In total, 83 peccaries kept in 0.25-1.50 hectare enclosures were immobilized via dart-administered anesthetic. Mean animal weight was 33.89±3.74 kg (standard deviation; n=77). The mean intramuscular (IM) anesthetic drug and dosages were 0.03±0.00 mg/kg of medetomidine, 0.91±0.10 mg/kg of Zoletil 50 (tiletamine-zolazepam), and 0.30±0.03 mg/kg azaperone. The mean time to recumbency after darting was 6.07±2.65 min. The mean time to reach the anesthetic plane postdarting was 10.00±2.00 min. Muscle relaxation was adequate to allow minor veterinary procedures. A mean dosage of 0.15±0.02 mg/kg of atipamezole was given IM to reverse the medetomidine. Recoveries were smooth and animals were standing by 59.17±30.18 min postreversal. Full recovery and release back to enclosures occurred 90±30 min postreversal. A single dose of this drug combination provided adequate anesthesia for 88% of adult Chacoan peccaries; 12% needed a supplemental dose of tiletamine-zolazepam because of failure to receive the full dose from the anesthetic dart. Sex and age did not impact the dosage required to achieve immobilization. Confinement during recovery from anesthesia is required with this protocol. Aside from mild hypoxemia, no adverse effects from anesthesia were observed. However, oxygen supplementation as a part of this protocol is recommended to support circulatory and respiratory capacity.


Assuntos
Anestésicos , Artiodáctilos , Animais , Medetomidina/farmacologia , Tiletamina , Zolazepam , Azaperona/farmacologia , Oxigênio , Paraguai , Combinação de Medicamentos , Artiodáctilos/fisiologia , Oxigenoterapia/veterinária , Imobilização/veterinária , Imobilização/métodos , Hipnóticos e Sedativos , Anestésicos Dissociativos
20.
Neurosci Lett ; 798: 137095, 2023 02 28.
Artigo em Inglês | MEDLINE | ID: mdl-36693556

RESUMO

Ketamine exerts anti-inflammatory, neuroprotective and neuroplastic activity, therefore it may counteract the neurotoxic processes underlying postoperative delirium. However, the majority of studies in this field failed. We identified several pharmacological reasons why these studies may have failed, together with suggestions of how to remediate them. Among them, the interaction with intravenous general anesthetics exerting the opposite effect on GABA interneurons than ketamine may be of principal importance. We suggest biomarkers which may elucidate the influence of this interaction on the different steps of neuroplastic pathways. We hypothesize that administering ketamine before or after general anesthesia could both prevent the interactions and strengthen the effect of ketamine by timing surgery within the climax of ketamine-induced neuroplastic changes or by stabilizing AMPA receptors. It is vital to deal with these questions because the protocols of ongoing studies are based again on the administration of ketamine during general anesthesia (the major identified pitfall).


Assuntos
Anestésicos Gerais , Delírio do Despertar , Ketamina , Humanos , Ketamina/uso terapêutico , Delírio do Despertar/tratamento farmacológico , Anestésicos Intravenosos , Anestesia Geral , Anestésicos Dissociativos
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