Evaluation of Clinical Factors Associated with Adverse Drug Events in Patients Receiving Sub-Anesthetic Ketamine Infusions
Alexander D Stoker,1 David M Rosenfeld,1 Matthew R Buras,2 Jeremy M Alvord,1 Andrew W Gorlin1 1Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Arizona, Phoenix, AZ, USA; 2Mayo Clinic Arizona, Phoenix, AZ, USACorrespondence: Alexander D StokerDepartment of Anesthesiology and Peri...
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doaj-ac58086637294a6ebde831fbca45fe6a2020-11-24T21:27:39ZengDove Medical PressJournal of Pain Research1178-70902019-12-01Volume 123413342150653Evaluation of Clinical Factors Associated with Adverse Drug Events in Patients Receiving Sub-Anesthetic Ketamine InfusionsStoker ADRosenfeld DMBuras MRAlvord JMGorlin AWAlexander D Stoker,1 David M Rosenfeld,1 Matthew R Buras,2 Jeremy M Alvord,1 Andrew W Gorlin1 1Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Arizona, Phoenix, AZ, USA; 2Mayo Clinic Arizona, Phoenix, AZ, USACorrespondence: Alexander D StokerDepartment of Anesthesiology and Perioperative Medicine, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ 85054, USATel +1 480-510-7933Email Stoker.Alexander@mayo.eduIntroduction: Sub-anesthetic ketamine is frequently used as an analgesic to reduce perioperative opioid consumption and has also been shown to have antidepressant effects. Side effects of ketamine include dizziness, diplopia, nystagmus, and psychomimetic effects. It is unclear what clinical factors may be associated with ketamine-related adverse drug events (ADEs).Methods: We performed a retrospective review of 95 patients who received sub-anesthetic ketamine infusions at our institution. Data examined associations between ketamine-related ADEs and various clinical characteristics including chronic pain, depression, or psychiatric disorder, patient physical characteristics, chronic opioid use, perioperative opioid use, dose and duration of ketamine infusions, pain scores, and perioperative medications such as serotonergic agents, central nervous system (CNS) depressants, and analgesics.Results: Overall incidence of ketamine-related ADEs was 29.5% and the incidence of psychomimetic effects was 14.8%. We observed that patients with a history of depression have a lower incidence of ketamine-related ADEs compared to patients without a history of depression (10.3% vs 37.3%; p value = 0.007).Conclusion: Patients with depression were found to have a statistically significant reduction in the incidence of ketamine-related ADEs. We found no statistically significant positive associations between ketamine-related ADEs and other clinical factors such as a history of chronic pain, psychiatric disease, patient physical characteristics, perioperative opioid use, dose of ketamine infusion, or co-administration of other CNS depressants.Keywords: ketamine, pain, depression, adverse, drug-eventhttps://www.dovepress.com/evaluation-of-clinical-factors-associated-with-adverse-drug-events-in--peer-reviewed-article-JPRketaminepaindepressionadversedrug-event |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Stoker AD Rosenfeld DM Buras MR Alvord JM Gorlin AW |
spellingShingle |
Stoker AD Rosenfeld DM Buras MR Alvord JM Gorlin AW Evaluation of Clinical Factors Associated with Adverse Drug Events in Patients Receiving Sub-Anesthetic Ketamine Infusions Journal of Pain Research ketamine pain depression adverse drug-event |
author_facet |
Stoker AD Rosenfeld DM Buras MR Alvord JM Gorlin AW |
author_sort |
Stoker AD |
title |
Evaluation of Clinical Factors Associated with Adverse Drug Events in Patients Receiving Sub-Anesthetic Ketamine Infusions |
title_short |
Evaluation of Clinical Factors Associated with Adverse Drug Events in Patients Receiving Sub-Anesthetic Ketamine Infusions |
title_full |
Evaluation of Clinical Factors Associated with Adverse Drug Events in Patients Receiving Sub-Anesthetic Ketamine Infusions |
title_fullStr |
Evaluation of Clinical Factors Associated with Adverse Drug Events in Patients Receiving Sub-Anesthetic Ketamine Infusions |
title_full_unstemmed |
Evaluation of Clinical Factors Associated with Adverse Drug Events in Patients Receiving Sub-Anesthetic Ketamine Infusions |
title_sort |
evaluation of clinical factors associated with adverse drug events in patients receiving sub-anesthetic ketamine infusions |
publisher |
Dove Medical Press |
series |
Journal of Pain Research |
issn |
1178-7090 |
publishDate |
2019-12-01 |
description |
Alexander D Stoker,1 David M Rosenfeld,1 Matthew R Buras,2 Jeremy M Alvord,1 Andrew W Gorlin1 1Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Arizona, Phoenix, AZ, USA; 2Mayo Clinic Arizona, Phoenix, AZ, USACorrespondence: Alexander D StokerDepartment of Anesthesiology and Perioperative Medicine, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ 85054, USATel +1 480-510-7933Email Stoker.Alexander@mayo.eduIntroduction: Sub-anesthetic ketamine is frequently used as an analgesic to reduce perioperative opioid consumption and has also been shown to have antidepressant effects. Side effects of ketamine include dizziness, diplopia, nystagmus, and psychomimetic effects. It is unclear what clinical factors may be associated with ketamine-related adverse drug events (ADEs).Methods: We performed a retrospective review of 95 patients who received sub-anesthetic ketamine infusions at our institution. Data examined associations between ketamine-related ADEs and various clinical characteristics including chronic pain, depression, or psychiatric disorder, patient physical characteristics, chronic opioid use, perioperative opioid use, dose and duration of ketamine infusions, pain scores, and perioperative medications such as serotonergic agents, central nervous system (CNS) depressants, and analgesics.Results: Overall incidence of ketamine-related ADEs was 29.5% and the incidence of psychomimetic effects was 14.8%. We observed that patients with a history of depression have a lower incidence of ketamine-related ADEs compared to patients without a history of depression (10.3% vs 37.3%; p value = 0.007).Conclusion: Patients with depression were found to have a statistically significant reduction in the incidence of ketamine-related ADEs. We found no statistically significant positive associations between ketamine-related ADEs and other clinical factors such as a history of chronic pain, psychiatric disease, patient physical characteristics, perioperative opioid use, dose of ketamine infusion, or co-administration of other CNS depressants.Keywords: ketamine, pain, depression, adverse, drug-event |
topic |
ketamine pain depression adverse drug-event |
url |
https://www.dovepress.com/evaluation-of-clinical-factors-associated-with-adverse-drug-events-in--peer-reviewed-article-JPR |
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