Der Anaesthesist
-
Review Randomized Controlled Trial Clinical Trial
[S-(+)-Ketamine and circulation].
The S-(+) isomer of ketamine has about twice the analgesic potency of the clinically used racemic mixture. Therefore, the known side effects may be reduced when one-half of the usual dose is administered. Several prospective, randomised, and double-blinded studies have been performed to assess whether the S-(+) isomer of ketamine is superior to the racemic mixture with respect to circulatory side effects. ⋯ One patient in the S-(+)-ketamine group showed severe arterial hypertension and tachycardia after induction of anaesthesia and was withdrawn from the study. With respect to haemodynamic changes, the pharmacodynamic effects of ketamine racemate and S-(+)-ketamine are comparable. Therefore, it can be concluded that neither ketamine nor S-(+)-ketamine should be used in patients who suffer, e.g., from arterial hypertension and coronary artery disease.
-
Randomized Controlled Trial Clinical Trial
[The preemptive action of ketoprofen. Randomized, double-blind study with gynecologic operations].
Ketoprofen exerts its clinical effect by inhibition of prostaglandin synthesis, but also acts as an NMDA-receptor antagonist by means of the kynurenic acid. Based on ketoprofen's supposed central mechanism of analgesia, we expected a preemptive effect, which was assessed by the present study. ⋯ Ketoprofen is an effective post-operative analgesic in combination with an opioid, but has no preemptive effect according to the results of this study.