![]() ![]() Like its chemical cousin phencyclidine, ketamine’s psychomimetic effects have made it a popular recreational drug. Off-label, subanesthetic doses of ketamine also have a use for acute and chronic pain management, sedation, and treatment of severe depression. In surgical settings, ketamine is typically combined with benzodiazepines, which can reduce the adverse psychological symptoms that occur during emergence. Intramuscular and intravenous forms of ketamine are commonly used to provide pediatric anesthesia, especially for high-risk children or patients in limited-resource settings. Originally called CI-581, ketamine has one-tenth the potency of PCP and causes less severe dysphoria and hallucinations. Similar to phencyclidine, ketamine causes analgesia and amnesia without the cardiovascular and respiratory depression associated with common anesthetics. Although the small sample size limited our ability to demonstrate significant genotype differences, we generated effect sizes, sample size estimates, and nongenetic covariates information in order to support future pharmacogenetic study design for evaluating this adverse event.Ketamine is a structural analog of the dissociative anesthetic and recreational drug phencyclidine (PCP). Younger age, higher dose, and longer duration of anesthesia significantly predicted EP occurrence and severity among our pilot sample. This pilot study demonstrates feasibility for implementing a pharmacogenetic study in a clinical setting, and we estimate that between 380 and 570 cases will be needed to adequately power future genetic association studies. Exploratory analysis of nongenotype models containing age, ketamine dose, duration of anesthesia, and time from ketamine administration to assessment for EP significantly predicted EP occurrence (p =. Occurrence and severity of EP were not associated with CYP2B6*6 or GRIN2B (p >. Genetic association of CYP2B6*6 and GRIN2B (rs1019385 and rs1806191) single-nucleotide polymorphisms and ketamine-induced EP occurrence and severity were tested using logistic and linear regression.įorty-seven patients (63%) received ketamine and were genotyped, and 40% of them experienced EP. EP was measured with the Clinician Administered Dissociative State Scale. This cross-sectional, pharmacogenetic candidate, gene pilot study recruited 75 patients having minor elective outpatient surgeries. ![]() The aim of the study was to investigate the feasibility and sample sizes required to explore the relationship between CYP2B6*6 and GRIN2B single-nucleotide polymorphisms and ketamine-induced EP. Up to 55% of patients who are administered ketamine experience an emergence phenomena (EP) that closely mimics schizophrenia and increases their risk of injury however, to date, no studies have investigated genetic association of ketamine-induced EP in healthy patients. ![]()
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