A 32-year-old man presented with profound jaundice, rigors and decreased appetite. Initial liver function tests (LFTs) were deranged in a cholestatic pattern with imaging demonstrating a dilated biliary system, with no filling defects. It has been observed that LFTs typically improve upon ketamine cessation, but this case demonstrated escalating hyperbilirubinaemia, despite ketamine cessation. Recurrent cholangitis and biliary duct stricturing were demonstrated on magnetic resonance cholangiopancreatography (MRCP). This prompted investigation of other biliary pathology and consideration for intervention.
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http://dx.doi.org/10.7759/cureus.11611 | DOI Listing |
Curr Pain Headache Rep
January 2025
Department of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, 71103, USA.
Purpose Of Review: Complex Regional Pain Syndrome (CRPS) is a neuropathic pain disorder characterized by pain disproportionate to the inciting event that is constant for an extended duration. Numerous treatment options for this condition have been explored with unsatisfactory results in many cases. Ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist typically used as an anesthetic and analgesic, presents a promising potential treatment for CRPS in patients who fail to respond to traditional therapies.
View Article and Find Full Text PDFCureus
November 2024
Diabetes and Endocrinology, United Lincolnshire Hospitals NHS Trust, Lincolnshire, GBR.
Ketamine is increasingly used as a recreational drug. The report outlines the various multi-organ dysfunctions identified following chronic abuse in a 24-year-old patient with no significant past medical history and the subsequent patient management. Besides ketamine cessation, other treatments only provide suboptimal relief to the damage inflicted by the toxic ketamine metabolites.
View Article and Find Full Text PDFAnn Emerg Med
December 2024
Department of Emergency Medicine, Mt. Sinai Medical Center, Miami Beach, FL; Department of Emergency Medicine and Critical Care, Herbert Wertheim College of Medicine at Florida International University, Miami, FL; Palm Beach County Fire Rescue, West Palm Beach, FL.
Study Objective: To determine if ketamine, when added to midazolam for the treatment of out-of-hospital seizures, is associated with an increase in the rate of cessation of convulsions prior to hospital arrival.
Methods: We performed a retrospective cohort study of out-of-hospital patients with an active convulsive seizure being transported to a hospital by a large emergency medical services system in Florida, using data from August 1, 2015 and August 5, 2024. Per protocol, patients received midazolam first for their seizure.
Brain Dev
December 2024
Working Group for the Revision of Treatment Guidelines for Pediatric Status Epilepticus/Convulsive Status Epilepticus, Japanese Society of Child Neurology, Tokyo, Japan; Committee for Integration of Guidelines, Japanese Society of Child Neurology, Tokyo, Japan; Division of Child Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Yonago, Japan.
World J Surg
December 2024
Mercer University School of Medicine, Columbus, Georgia, USA.
Introduction: Evidence-based principles in enhanced recovery programs (ERPs) demonstrate substantial improvement in patient outcomes. Determining which latent variables predict composite outcomes could refine ERP pharmacotherapy recommendations.
Methods: Using R, pharmacotherapy data were modeled from an existing dataset of adult elective colorectal surgery patients.
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