Ketamine is one of the most commonly used anesthetics in human and veterinary medicine, but its clinical effectiveness is often compromised due to tolerance to its anesthetic effects. Although ketamine tolerance has been demonstrated in a number of behavioral measures, no published work has investigated tolerance to ketamine's anesthetic effects other than duration of anesthesia. In addition, a reported practice in anesthesiology is to alter anesthetic doses for procedures when the patient has a history of drug abuse. Empirically investigating the effects of administration of a drug of abuse on ketamine's potency and efficacy to produce anesthesia could help in the creation of anesthetic plans that maximize safety for both clinicians and patients. The goal of the current study was to test the effects of repeated administration of ketamine, morphine, or cocaine on ketamine's ability to produce anesthesia. In 2 studies, male Sprague-Dawley rats received daily injections of ketamine (32 or 100 mg/kg IP), morphine (3.2 or 5.6 mg/kg IP), or cocaine (3.2 or 10 mg/kg IP) for 14 consecutive days and then were tested on day 15 for ketamine-induced anesthesia by using a cumulative-dosing procedure (32 to 320 mg/kg IP). Chronic treatment with either ketamine or morphine-but not cocaine-produced tolerance to ketamine's anesthetic effects in a dose-dependent manner. These results suggest that ketamine's clinical effectiveness as an anesthetic will vary as a function of its history of use. Furthermore, given that chronic morphine administration produced tolerance to ketamine's anesthetic effects, various pain medications may reduce ketamine's effectiveness for anesthesia.
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http://dx.doi.org/10.30802/AALAS-CM-18-000053 | DOI Listing |
Sci Rep
December 2024
Department of Anesthesia and Perioperative Medicine, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, Qingdao, China.
Toluene sulfonic acid remimazolam is a novel benzodiazepine that differs from traditional benzodiazepines (BZDs) due to its rapid onset, swift metabolism, and lack of hepatic or renal metabolism, as well as its reduced effects on cardiac and cerebral functions. Despite its potential advantages, clinical experience with this agent remains limited. This study investigated the effect of remizolam on postoperative delirium in elderly patients undergoing painless bronchoscopy.
View Article and Find Full Text PDFEnviron Toxicol Pharmacol
December 2024
São Paulo State University (UNESP), Medical School, Division of Anesthesiology, GENOTOX Lab., Botucatu, São Paulo, Brazil. Electronic address:
Waste anesthetic gases (WAGs) are trace-concentration inhaled anesthetics that exist worldwide because they are released into the ambient air of operating rooms (ORs) and post-anesthesia care units. WAGs cause indoor contamination, especially in ORs lacking proper scavenging systems, and occupational exposure, while promoting climate change through greenhouse gas/ozone-depleting effects. Despite these controversial features, WAGs continue to pose occupational health hazards.
View Article and Find Full Text PDFZh Nevrol Psikhiatr Im S S Korsakova
December 2024
Research Center of Neurology, Moscow, Russia.
Nitrous oxide (NO) intoxication is a common consequence of its inhalation with recreational purpose, which is prevalent among young people. The most severe result of such an entertainment is development of myelopolyneuropathy with polyneuropathy as the most common presentation, which may start acutely or subacutely. The underlying cause of neurological complications of NO intoxication is deficit of B vitamin, however its laboratory confirmation may be challenging.
View Article and Find Full Text PDFBMC Anesthesiol
December 2024
Department of Anesthesiology, Cangzhou Central Hospital, Cangzhou, Hebei, China.
Objectives: To explore the effect of mild cognitive impairment (MCI) and MCI with sleep disorders on the potency of sevoflurane anesthesia in the elderly.
Design: Prospective study methods. Dixon up-and-down methods.
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