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Papel de la ketamina en el tratamiento del dolor en adultos y en pediatría

tit

Ketamine an N-methyl-D-aspartate (NMDA) receptor blocking agent and a dissociative anesthetic with neurostimulatory side effects. In recent years, multiple research trials as well as systematic reviews and meta-analyses suggest the usefulness of ketamine as a strong analgesic used in subanesthetic intravenous doses, and also as a sedative. In addition, ketamine was noted to possess properties of anti-tolerance, anti-hyperalgesia and anti-allodynia most likely secondary to inhibition of the NMDA receptors. Tolerance, hyperalgesia and allodynia phenomena are the main components of opioid resistance, and pathological pain is often seen in the clinical conditions involving neuropathic pain, opioid-induced hyperalgesia, and central sensitization with allodynia or hyperalgesia. All these conditions are challenging to treat. In low doses, ketamine does not have major adverse dysphoric effects and also has the favorable effects of reduced incidence of opioid-induced nausea and vomiting. Therefore, ketamine can be a useful adjunct for pain control after surgery. Additional studies are required to determine the role of ketamine in the immediate postoperative period after surgical interventions known to produce severe pain and in the prevention and treatment of chronic pain.

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Grupo de trabajo de Intervencionismo y Neuromodulación

Coordinador:
Dr. J. M. Trinidad Martín-Arroyo.

Vocales: 
A. Martínez Navas, J. Maldonado Contreras, R. de Alba Moreno, J. M. González Mesa.

Artículos relacionados:

Radiofrecuencia pulsada: pasan los años y seguimos con las mismas incógnitas

Lumbosacral Radicular Pain

Pain Originating from the Lumbar Facet Joints

Complex Regional Pain Syndrome

Radiofrequency for the Treatment of Lumbar Radicular Pain: Impact on Surgical Indications

Grupo de trabajo de ecografía.

Coordinado por los Dres. Diego Benítez y Manuel Jesús Sánchez del Águila.

Vocal: Francisco Miralles

Artículos relacionados:

Basic considerations before injections and scanning techniques

Estudio e intervencionismo ecoguiado de la articulación del hombro

Ultrasound-Guided Superior Hypogastric Plexus Block: A Cadaveric Feasibility Study with Fluoroscopic Confirmation

Comparison of Fluoroscopy and Ultrasound Guidance for Sacroiliac Joint Injection in Patients with Chronic Low Back Pain

Ultrasound-guided pain interventions in the hip region

Ultrasound-guided interventional procedures for cervical pain

Ultrasonography in Pain Medicine: A Critical Review

Ultrasound-guided pain interventions in shoulder region

Ultrasound-guided interventional procedures for lumbar pain

Ultrasound Imaging of Embedded Shrapnel Facilitates Diagnosis and Management of Myofascial Pain Syndrome

Myofascial trigger points: New insights in ultrasound imaging

Ultrasound-guided pain interventions in the pelvis and the sacral spine

Ultrasound-guided pain interventions in the knee region

Effectiveness of Ultrasound-Guided Versus Fluoroscopy or Computed Tomography Scanning Guidance in Lumbar Facet Joint Injections in Adults With Facet Joint Syndrome: A Meta-Analysis of Controlled Trials

Grupo de trabajo de opioides

Coordinador: Fernando Neira Reina.

Vocales: J. Luisa Ortega García (portavoz de la JD), Sebastián Perales Recio. Ignacio Velázquez Rivera

Documentación específica para Socios de la AAD

Acceda con su usuario y contraseña y pulse aquí para consultar documentación adicional.

Artículos relacionados

– CDC guideline for prescribing opioids for chronic pain — United States, 2016

– Practice guidelines for the prevention, detection, and management of respiratory depression associated with neuraxial opioid administration: an updated report by the American Society of Anesthesiologists Task Force on Neuraxial Opioids and the American Society of Regional Anesthesia and Pain Medicine.

– A Guideline for the Clinical Management of Opioid Use Disorder.

European Pain Federation position paper on appropriate opioid use in chronic pain management.

Evaluación de la calidad de atención al paciente anciano con dolor crónico y dolor irruptor en tratamiento con opioides. Estudio SAND.

Guideline for opioid therapy and chronic noncancer pain. CMAJ May 8, 2017 vol. 189 no. 18 doi: 10.1503/cmaj.170363

British Columbia Centre on Substance Use and B.C. Ministry of Health. A Guideline for the Clinical Management of Opioid Use Disorder. Published June 5, 2017.

Paice JA, Portenoy R, Lacchetti C, Campbell T, Cheville A, Citron M, Constine LS, Cooper A, Glare P, Keefe F, Koyyalagunta L, Levy M, Miaskowski C, Otis-Green S, Sloan P, Bruera E. Management of chronic pain in survivors of adult cancers: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol. 2016 Sep 20;34(27):3325-45. [114 references]

Grupo de trabajo de dolor postoperatorio.

Coordinado por el Prof. Luis Miguel Torres Morera.

Artículos relacionados:

Preemptive Oral Gabapentin and Pregabilin for Post-Operative Pain Management after Surgery under Spinal Subarachnoid Block

Analgesia regional en el paciente crítico
posquirúrgico

Abordaje del Dolor Agudo