Abstract:
BACKGROUND:When administered as a continuous infusion, ketamine is known to be a potent analgesic and general anaesthetic. Recent studies suggest that a single low-dose administration of ketamine can provide a long-lasting effect on mood, but its effects when given in the postoperative period have not been studied. OBJECTIVE:We hypothesised that a single low-dose administration of ketamine after bariatric surgery can improve pain and mood scores in the immediate postoperative period. DESIGN:We performed a randomised, double-blind, placebo-controlled study to compare a single subanaesthetic dose of ketamine (0.4 mg kg) with a normal saline placebo in the postanaesthesia care unit after laparoscopic gastric bypass and gastrectomy. SETTING:Single-centre, tertiary care hospital, October 2014 to January 2018. PATIENTS:A total of 100 patients were randomised into the ketamine and saline groups. INTERVENTION:Patients in the ketamine group received a single dose of ketamine infusion (0.4 mg kg) in the postanaesthesia care unit. Patients in the placebo groups received 0.9% saline. OUTCOME MEASURES:The primary outcome was the visual analogue pain score. A secondary outcome was performance on the short-form McGill's Pain Questionnaire (SF-MPQ). RESULTS:There were no significant differences in visual analogue pain scores between groups (group-by-time interaction P = 0.966; marginal group effect P = 0.137). However, scores on the affective scale of SF-MPQ (secondary outcome) significantly decreased in the ketamine group as early as postoperative day (POD) 2 [mean difference = -2.2 (95% bootstrap CI -2.9 to 1.6), Bonferroni adjusted P < 0.001], compared with placebo group in which the scores decreased only by POD 7. Scores on the total scale of SF-MPQ for the ketamine group were smaller compared with the placebo group (P = 0.034). CONCLUSION:Although there was no significant difference between ketamine and placebo for the primary outcome measure, patients who received ketamine experienced statistically and clinically significant improvement in their comprehensive evaluation of pain, particularly the affective component of pain, on POD 2. However, future studies are needed to confirm the enduring effects of ketamine on the affective response to postoperative pain. CLINICAL TRIAL REGISTRATION:NCT02452060. : This article is accompanied by the following Invited Commentaries:Mion G. Ketamine stakes in 2018. Right doses, good choices. Eur J Anaesthesiol 2019; 36:1-3.Robu B, Lavand'homme, P. Targeting the affective component of pain with ketamine. A tool to improve the postoperative experience? Eur J Anaesthesiol 2019; 36:4-5.
journal_name
Eur J Anaesthesioljournal_title
European journal of anaesthesiologyauthors
Wang J,Echevarria GC,Doan L,Ekasumara N,Calvino S,Chae F,Martinez E,Robinson E,Cuff G,Franco L,Muntyan I,Kurian M,Schwack BF,Bedrosian AS,Fielding GA,Ren-Fielding CJdoi
10.1097/EJA.0000000000000860subject
Has Abstractpub_date
2019-01-01 00:00:00pages
16-24issue
1eissn
0265-0215issn
1365-2346journal_volume
36pub_type
杂志文章,随机对照试验abstract:BACKGROUND:Previous data show that lidocaine or magnesium has unique characteristics of stress inhibition and antiinflammation. OBJECTIVE:We aimed to observe the effects of lidocaine or magnesium on the quality of recovery (QoR) after laparoscopic cholecystectomy. DESIGN:Single-centre, prospective, randomised, double...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000001348
更新日期:2021-03-01 00:00:00
abstract::Diazepam premedication decreases the overall metabolic rate and oxygen consumption. Whether its properties are shared by midazolam is not known. In this study, eight healthy male volunteers were given oral diazepam (10 mg), midazolam (15 mg) and placebo in a random double-blind cross-over fashion. Metabolic responses ...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1994-09-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Statins are prescribed for patients with hypercholesterolemia. Atorvastatin is metabolized by cytochrome P4503A4 and inhibits P4503A4 activity in vitro. Alfentanil is a potent opioid used in clinical anaesthetic practice and is also metabolized by P4503A4. This study tested the hypothesis that ...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章
doi:10.1017/s0265021503001078
更新日期:2003-08-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Several reports concerning the haemodynamic changes during gynaecologic laparoscopy have been published so far, and the effects of head-down tilt and pneumoperitoneum have not been clearly separated. However, its main effect seems to be an increase in systemic vascular resistance. We investigat...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0b013e32832cb3c9
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:We assessed the intraoperative haemodynamic responses and recovery profiles of total intravenous anaesthesia with remifentanil and alfentanil for outpatient surgery. METHODS:Patients in Group 1 (n = 20) received alfentanil 20 microg kg(-1) followed by 2 microg kg(-1) min(-1) intravenously; pat...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/s0265021503000115
更新日期:2003-01-01 00:00:00
abstract::Pulmonary hypertension is usually treated with intravenous (i.v.) vasodilators, but their use is limited by systemic effects. In the current study, we compared the effects of inhaled nitric oxide and intravenous nitroglycerine on pulmonary and systemic haemodynamic responses as well as on gas exchange measurements in ...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1046/j.1365-2346.1996.d01-384.x
更新日期:1996-09-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The modified Airway Management Device (AMD) and the Proseal laryngeal mask airway (PLMA) are both supraglottic airway devices designed to maintain airway patency and allow ventilation during anaesthesia. In this prospective, randomized trial, we compared the two devices in patients undergoing m...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1017/S0265021505001808
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The electroencephalographic Narcotrend Index was evaluated as a measure of sedation in mechanically ventilated intensive care unit patients. Narcotrend Index and conventional electroencephalography parameter values were compared to the Richmond Agitation-Sedation Scale and a simplified three-le...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/S0265021507001329
更新日期:2008-02-01 00:00:00
abstract::Survey results continue to reveal that postoperative pain is insufficiently managed throughout Europe and the rest of the world. However, the efficient use of existing resources, as well as the introduction of novel technologies, may aid in its improvement. Use of an acute pain service has the potential to improve pai...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,评审
doi:10.1017/S026502150600189X
更新日期:2007-04-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Administration of calcium safely and effectively reverses many of the electrophysiological actions of hyperkalaemia, but it has not been studied for pretreatment. Based on cellular studies, magnesium also has been suggested to prevent the effects of potassium on the heart. As their mechanisms o...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/s0265021503000978
更新日期:2003-08-01 00:00:00
abstract:BACKGROUND:Effective postoperative analgesia after caesarean section is important because it enables early ambulation and facilitates breast-feeding. Several case reports have shown that local anaesthetic injection around the quadratus lumborum muscle is effective in providing pain relief after various abdominal operat...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/EJA.0000000000000299
更新日期:2015-11-01 00:00:00
abstract::The purpose of this guideline is to present evidence-based and consensus-based recommendations for the prevention and treatment of postoperative delirium. The cornerstones of the guideline are the preoperative identification and handling of patients at risk, adequate intraoperative care, postoperative detection of del...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,评审
doi:10.1097/EJA.0000000000000594
更新日期:2017-04-01 00:00:00
abstract::The effect of the administration of a 50 mg dose of an angiotensin converting enzyme inhibitor (captopril) on the mean arterial pressure following sternotomy in 13 patients undergoing coronary artery bypass surgery was indistinguishable from the response in 13 patients who had not received the drug. ...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1984-09-01 00:00:00
abstract:BACKGROUND:Currently used pre-operative prediction scores for postoperative pulmonary complications (PPCs) use patient data and expected surgery characteristics exclusively. However, intra-operative events are also associated with the development of PPCs. OBJECTIVE:We aimed to develop a new prediction score for PPCs t...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,多中心研究
doi:10.1097/EJA.0000000000000845
更新日期:2018-09-01 00:00:00
abstract::The pharmacokinetics of lorazepam premedication were studied in 16 patients using two different formulations (intravenous and FDDF oral administrations). Arterial blood samples were taken at intervals for up to 600 min after administration of 4 mg of each formulation, and plasma lorazepam concentrations were determine...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1988-07-01 00:00:00
abstract::We report the case of a 33-year-old woman who developed a dense hemiplegia immediately after an uncomplicated general anaesthetic for diagnostic laparoscopy. She had a history of recurrent hemiplegic migraine with a strong family history. Her migraine was normally associated with visual disturbances and a unilateral h...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1046/j.1365-2346.1998.00368.x
更新日期:1998-09-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Drug mixtures containing sufentanil may be unstable owing to absorption into the drug reservoirs of patient-controlled epidural analgesia systems that contain polyvinylchloride. The stability of sufentanil in a mixture of ropivacaine 0.2% in a 750 mL reservoir was therefore investigated. METHO...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/s0265021502000479
更新日期:2002-04-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Previous studies have shown that general anaesthetic agents modulate the production of hypothalamic prostaglandins (PG) D2 and E2, which are mediators of sleep and wakefulness respectively. Although flurbiprofen, a cyclo-oxygenase inhibitor, is used clinically as a non-steroidal anti-inflammato...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/s0265021502000790
更新日期:2002-07-01 00:00:00
abstract::Propofol and isoflurane were compared for haemodynamic stability and recovery time as main anaesthetic agents for maintenance in a total of 43 ASA I and II patients in uncomplicated operations lasting at least 30 min. The premedication (oral diazepam), induction (thiopentone-fentanyl-suxamethonium) and maintenance pro...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1994-11-01 00:00:00
abstract::The effects of progressive curarization on spontaneous ventilation were studied in 23 patients during light halothane-nitrous oxide-oxygen anaesthesia. In 11 patients, in whom the end-expiratory CO2 concentration and evoked mechanical response were recorded, increasing curarization caused first a slow CO2 accumulation...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1984-06-01 00:00:00
abstract::In order to compare the neuromuscular effects following rocuronium 0.6 mg kg-1 and atracurium 0.5 mg kg-1 30 children aged from 18 to 67 months were studied under the same anaesthetic conditions. After induction of anaesthesia with etomidate and fentanyl, neuromuscular blockade was monitored by recording the electromy...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1365-2346.1998.00294.x
更新日期:1998-05-01 00:00:00
abstract:BACKGROUND:Many trauma centres have adopted the administration of fixed ratios of packed red blood cells (PRBCs), platelet concentrates and fresh frozen plasma (FFP) for bleeding patients. However, the haemostatic efficacy of this concept is not well proven. OBJECTIVE:Our objective was to characterise the haemostatic ...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000001202
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Ultrasound guidance improves the efficacy of peripheral nerve blocks, reducing performance time and local anaesthetic doses. It should also reduce the risk of systemic toxicity of local anaesthetic and nerve injuries. OBJECTIVE:The primary objective of this prospective study was to estimate the incidence of...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,多中心研究
doi:10.1097/EJA.0000000000000063
更新日期:2014-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:To evaluate the noninvasive electrical velocimetry (Aesculon) monitor for cardiac output (CO) by subxiphoidal Doppler flow measurement in children. METHODS:CO was determined at the end of diagnostic or interventional cardiac catheterization for congenital heart defects. Standard ECG surface el...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0b013e3283240438
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The effects of bicarbonated Ringer's solution were evaluated and compared with those of acetated Ringer's, lactated Ringer's and Ringer's solutions in partially hepatectomized rabbits. METHOD:Animals were randomly divided into six groups (n = 6 in each group): a sham-operated group, an operate...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/s0265021505001043
更新日期:2005-08-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Arterial grafts are prone to vasospasm. Opioid analgesics are commonly used in the perioperative course of cardiac surgical procedures. Therefore, we investigated the direct effects of morphine, meperidine, fentanyl and remifentanil on the human radial artery. METHODS:Radial artery segments, o...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/S0265021506000172
更新日期:2006-06-01 00:00:00
abstract:INTRODUCTION:We tested the hypothesis that repeated autoclaving removes protein deposits from the classic laryngeal mask airway (LMA). METHODS:Twenty previously used LMAs were hand washed, machine washed, dried, autoclaved and randomly allocated into four equal-sized groups for repeat autoclaving on 0 (control), 1, 2 ...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/s0265021505000888
更新日期:2005-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:This study was performed to compare three disposable airway devices, the LMA Unique (LMA-U), the Ambu laryngeal mask (Ambu LM) and the Soft Seal laryngeal mask (Soft Seal LM) for elective general anaesthesia during controlled ventilation in non-paralysed patients. METHODS:One hundred and twent...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1017/S0265021506001219
更新日期:2007-02-01 00:00:00
abstract::We present a case of pulmonary embolism that occurred during the injection of lipiodol during transcatheter arterial chemoembolization under general anaesthesia. A 7-year-old child suffering from a large hepatoblastoma was admitted for arterial chemoembolization and carcinostatic administration. Pulmonary embolism due...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1046/j.1365-2346.2000.00759.x
更新日期:2000-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Unilateral spinal anaesthesia is a useful anaesthesia technique in lower abdominal surgery, especially in an outpatient setting. Patient posture is pivotal in the achievement of unilateral anaesthesia. Nevertheless, no studies have elucidated the influence of patient posture during the anaesthe...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1017/S0265021506000020
更新日期:2006-06-01 00:00:00