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Assessment of Ketamine’s Influence on In Vitro Angiogenesis
Kazumi TakaishiDDS, PhD,
Marina TakataDDS,
Mika NishikawaDDS,
Hiroshi KitahataMD, PhD, and
Shinji KawahitoMD, PhD
Article Category: Research Article
Volume/Issue: Volume 71: Issue 4
Online Publication Date: Dec 04, 2024
DOI: 10.2344/23-0011
Page Range: 176 – 182

Ketamine is an ionotropic, glutamatergic, N-methyl-D-aspartate receptor antagonist often used in total intravenous anesthesia 1 that also has anti-inflammatory effects and is a beneficial antidepressant for treatment-resistant depression. 2 , 3 The frequency of its anesthetic use may be increasing due to COVID-19-related restrictions on the use of some intravenous anesthetics. It is important for anesthesiologists to understand the effects of perioperative and long-term use of anesthetics and analgesics on angiogenesis. We recently reported about the

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Retrospective Comparison of Intramuscular Admixtures of Ketamine and Dexmedetomidine Versus Ketamine and Midazolam for Preoperative Sedation
David B. GuthrieDMD,
Martin R. BoorinDMD,
Andrew R. SistiBA,
Ralph H. EpsteinDDS,
Jamie L. RomeiserMPH,
David K. LamMD, DDS, PhD,
Tong J. GanMD, MBA, MHS, and
Elliott Bennett-GuerreroMD
Article Category: Research Article
Volume/Issue: Volume 68: Issue 1
Online Publication Date: Apr 07, 2021
DOI: 10.2344/anpr-67-04-02
Page Range: 3 – 9

, combative and violent behavior may pose a physical danger to the patient, caretakers, and the anesthesia care team. The use of intramuscular (IM) sedative agents, which does not require patient cooperation, can facilitate an efficient transfer to the OR and induction of GA. Although IM ketamine is effective and commonly used for the management of special need patients, it has numerous undesirable side effects including dysphoria, hypersalivation, hyperreactive airway reflexes, hypertension, tachycardia, muscle hypertonia, hallucinations, increased incidence of

Dexmedetomidine, Ketamine, and Midazolam for Oral Rehabilitation: A Case Report
Bill W. S. KimDMD, MSc and
Robert M. PeskinDDS
Article Category: Other
Volume/Issue: Volume 62: Issue 1
Online Publication Date: Jan 01, 2015
DOI: 10.2344/0003-3006-62.1.25
Page Range: 25 – 30

use of intravenous dexmedetomidine and ketamine for dental extraction in children with cyanotic heart disease with positive results. 17 Both midazolam and ketamine are intravenous sedative agents used most commonly in combination with other drugs for dental procedures. Midazolam is a good anxiolytic, amnestic agent but is known to pose difficulties to the operator for longer and more complex dental procedures when used alone. 18 It also poses the risk of respiratory depression at high doses and has minimal analgesic effects, 19 , 20 limiting its utility as

Comparison of Propofol-Remifentanil Versus Propofol-Ketamine Deep Sedation for Third Molar Surgery
Kyle J. KramerDDS, MS,
Steven GanzbergDMD, MS,
Simon PriorBDS, PhD, MS, and
Robert G. RashidDDS, MAS
Article Category: Other
Volume/Issue: Volume 59: Issue 3
Online Publication Date: Jan 01, 2012
DOI: 10.2344/12-00001.1
Page Range: 107 – 117

from the dental office. These adverse effects may be mitigated by avoiding or minimizing opioid dosages or by utilizing a rapidly metabolized opioid such as remifentanil. 6 Continuous infusion of subhypnotic doses of propofol has been used successfully to prevent and treat PONV. 7 , 8 Infusion of propofol in combination with remifentanil has been demonstrated to decrease the incidence of PONV in comparison to an infusion of remifentanil alone. 9 Ketamine, a phencyclidine derivative, is an N-methyl-D-aspartate (NMDA) receptor antagonist that produces a state

Anesthetic Management of a Complex Regional Pain Syndrome (CRPS) Patient With Ketamine
Tarun MundluruBDS, MSc and
Mana SaraghiDMD
Article Category: Case Report
Volume/Issue: Volume 67: Issue 4
Online Publication Date: Dec 31, 2020
DOI: 10.2344/anpr-67-02-07
Page Range: 219 – 225

, and patients may experience signs and symptoms in other parts of the body. Although the pattern of spread is not well understood, involvement spreading to the contralateral limb is usually 2.3 times higher than the ipsilateral and diagonal area. Diagonal spread is usually triggered by new trauma, unlike ipsilateral and contralateral spread. 18 CRPS Management and Ketamine Specific treatment protocols for CRPS types I and II are not yet well-defined. Treatment modalities have included bisphosphonates, botulinum toxin A, calcitonin

Figure 1.;  Effects of Ketamine on Cell Proliferation HUVEC (A) and NHDF (B) were stimulated with ketamine at 1, 10, and 50 µM (K1, K10, and K50, respectively; C, control) and incubated for 48 hours. Ketamine did not significantly influence HUVEC and NHDF proliferation at 48 hours. Abbreviations: HUVEC, human umbilical vein endothelial cells; NHDF, normal human diploid fibroblasts.
Kazumi Takaishi,
Marina Takata,
Mika Nishikawa,
Hiroshi Kitahata, and
Shinji Kawahito
Figure 1.
Figure 1.

 Effects of Ketamine on Cell Proliferation

HUVEC (A) and NHDF (B) were stimulated with ketamine at 1, 10, and 50 µM (K1, K10, and K50, respectively; C, control) and incubated for 48 hours. Ketamine did not significantly influence HUVEC and NHDF proliferation at 48 hours. Abbreviations: HUVEC, human umbilical vein endothelial cells; NHDF, normal human diploid fibroblasts.

Figure 2.; Effects of Ketamine on Endothelial Cell Migration Control: Fluorescence intensity of calcein AM in HUVEC incubated with medium containing 2% FBS (FBS+) or no FBS (FBS-) for 22 hours. Ketamine: Fluorescence intensity of calcein AM in HUVEC stimulated by 50 µM ketamine with FBS- or FBS+ for 22 hours. Ketamine did not significantly influence migration in non-stimulated or FBS-stimulated HUVEC. * indicates P < .001 compared with the migration of HUVEC in Control group without FBS. Abbreviations: FBS, fetal bovine serum; HUVEC, human umbilical vein endothelial cells.
Kazumi Takaishi,
Marina Takata,
Mika Nishikawa,
Hiroshi Kitahata, and
Shinji Kawahito
Figure 2.
Figure 2.

Effects of Ketamine on Endothelial Cell Migration

Control: Fluorescence intensity of calcein AM in HUVEC incubated with medium containing 2% FBS (FBS+) or no FBS (FBS-) for 22 hours. Ketamine: Fluorescence intensity of calcein AM in HUVEC stimulated by 50 µM ketamine with FBS- or FBS+ for 22 hours. Ketamine did not significantly influence migration in non-stimulated or FBS-stimulated HUVEC. * indicates P < .001 compared with the migration of HUVEC in Control group without FBS. Abbreviations: FBS, fetal bovine serum; HUVEC, human umbilical vein endothelial cells.

Figure 3.; Effects of Ketamine on Capillary Tube Formation After Incubation for 3 Days We assessed the area (A) and length (B) of tubules and the numbers of joints (C) and paths (D) to determine the effects of ketamine on in vitro capillary tube formation. VEGF significantly stimulated in vitro capillary tube formation in all aspects. Ketamine (50 µM) did not significantly influence any of the components of in vitro capillary tube formation stimulated with or without VEGF. Data are expressed as mean ± SD; * indicates P < .001 compared with no stimulation. Abbreviation: VEGF, vascular endothelial growth factor.
Kazumi Takaishi,
Marina Takata,
Mika Nishikawa,
Hiroshi Kitahata, and
Shinji Kawahito
Figure 3.
Figure 3.

Effects of Ketamine on Capillary Tube Formation After Incubation for 3 Days

We assessed the area (A) and length (B) of tubules and the numbers of joints (C) and paths (D) to determine the effects of ketamine on in vitro capillary tube formation. VEGF significantly stimulated in vitro capillary tube formation in all aspects. Ketamine (50 µM) did not significantly influence any of the components of in vitro capillary tube formation stimulated with or without VEGF. Data are expressed as mean ± SD; * indicates P < .001 compared with no stimulation. Abbreviation: VEGF, vascular endothelial growth factor.

Figure 4.; Effects of Ketamine on Capillary Tube Formation After Incubation for 10 Days We assessed the area (A) and length (B) of the tubules and the number of joints (C) and paths (D) to determine the effects of ketamine on in vitro capillary tube formation. VEGF significantly stimulated in vitro capillary tube formation in all aspects, while suramin significantly inhibited all aspects with VEGF. Ketamine (10, 50 µM) did not significantly influence any of the components of in vitro capillary tube formation with or without VEGF. Data are expressed as mean ± SD; * indicates P < .001 compared with no stimulation; § indicates P < .001 compared with VEGF (positive control). Abbreviation: VEGF, vascular endothelial growth factor.
Kazumi Takaishi,
Marina Takata,
Mika Nishikawa,
Hiroshi Kitahata, and
Shinji Kawahito
Figure 4.
Figure 4.

Effects of Ketamine on Capillary Tube Formation After Incubation for 10 Days

We assessed the area (A) and length (B) of the tubules and the number of joints (C) and paths (D) to determine the effects of ketamine on in vitro capillary tube formation. VEGF significantly stimulated in vitro capillary tube formation in all aspects, while suramin significantly inhibited all aspects with VEGF. Ketamine (10, 50 µM) did not significantly influence any of the components of in vitro capillary tube formation with or without VEGF. Data are expressed as mean ± SD; * indicates P < .001 compared with no stimulation; § indicates P < .001 compared with VEGF (positive control). Abbreviation: VEGF, vascular endothelial growth factor.

Anesthetic Management of a Patient With Systemic Sclerosis and Microstomia
Yoshiki ShionoyaDDS, PhD,
Hatsuko KamigaDDS,
Gentarou TsujimotoDDS, PhD,
Eishi NakamuraDDS,
Kiminari NakamuraDDS, PhD, and
Katsuhisa SunadaDDS, PhD
Article Category: Case Report
Volume/Issue: Volume 67: Issue 1
Online Publication Date: Jan 01, 2020
DOI: 10.2344/anpr-66-03-07
Page Range: 28 – 34

of which is ketamine. Ketamine is an N -methyl- d -aspartate receptor antagonist often used to provide sedation and/or augment analgesia in painful surgical procedures. 10 Ketamine causes an increase in sympathetic tone, leading to an increased heart rate (HR), cardiac output, and blood pressure (BP). In addition, ketamine preserves the airway reflexes and produces minimal respiratory depression. 11 , 12 However, its cardiostimulatory effects and unwanted side effects, which include hypersalivation, 13 limit its use as a single intravenous agent for