caa a22 4500 477107699 CHVBK 20180405111559.0 cr unu---uuuuu 170330e19961001xx s 000 0 eng 10.1007/BF01809750 doi (NATIONALLICENCE)springer-10.1007/BF01809750 Ketamine for analgosedative therapy in intensive care treatment of head-injured patients [Elektronische Daten] [H. Kolenda, A. Gremmelt, S. Rading, U. Braun, E. Markakis] Summary: Ketamine was supposed to be contra-indicated in head injured patients although it possesses numerous advantages over other commonly used analgosedative drugs. Referring to these potential advantages and the lack of definitive data about its effect upon ICP, CPP or neurological development, we conducted a prospective study in which moderate or severely head injured patients (n=35) were prospectively allocated to receive treatment either with a combination of ketamine and midazolam or fentanyl and midazolam. The initial dose was 6.5 mg/kg/day midazolam, 65 mg/kg/day ketamine or 65 μg/kg/day fentanyl and was later adjusted due to clinical requirements for a period of 3 to 14 days. Comparably high dosages of detamine have been found necessary (104 mg/kg/day). Four patients from the ketamine group (n=17) and 5 from the control group (n=18) were withdrawn during treatment due to persistent ICP above 25 mm Hg, countermeasured by barbiturate coma. Two more patients were withdrawn due to development of cardiovascular arrest (ketamine group) and multi organ failure. A comparison of the remaining patients revealed a lower requirement of catecholamines (significant on first day, p<0.05), an on average 8 mm Hg higher cerebral perfusion pressure and a 2 mm Hg higher intracranial pressure in the fentanyl group. Enterai food intake was better in the study group. The outcome was comparable in both groups with or without inclusion of withdrawn patients. Springer-Verlag, 1996 Head injury nationallicence ketamine nationallicence midazolam nationallicence clinical study nationallicence Kolenda H. Department of Neurosurgery, University Clinic of Göttingen, Federal Republic of Germany aut Gremmelt A. Centre of Anaesthesiologie, Rescue- and Intensive Care Medicine, University Clinic of Göttingen, Federal Republic of Germany aut Rading S. Department of Neurosurgery, University Clinic of Göttingen, Federal Republic of Germany aut Braun U. Centre of Anaesthesiologie, Rescue- and Intensive Care Medicine, University Clinic of Göttingen, Federal Republic of Germany aut Markakis E. Department of Neurosurgery, University Clinic of Göttingen, Federal Republic of Germany aut Acta Neurochirurgica Springer-Verlag 138/10(1996-10-01), 1193-1199 0001-6268 138:10<1193 1996 138 701 https://doi.org/10.1007/BF01809750 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF01809750 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kolenda H. Department of Neurosurgery, University Clinic of Göttingen, Federal Republic of Germany aut NATIONALLICENCE 700 1- Gremmelt A. Centre of Anaesthesiologie, Rescue- and Intensive Care Medicine, University Clinic of Göttingen, Federal Republic of Germany aut NATIONALLICENCE 700 1- Rading S. Department of Neurosurgery, University Clinic of Göttingen, Federal Republic of Germany aut NATIONALLICENCE 700 1- Braun U. Centre of Anaesthesiologie, Rescue- and Intensive Care Medicine, University Clinic of Göttingen, Federal Republic of Germany aut NATIONALLICENCE 700 1- Markakis E. Department of Neurosurgery, University Clinic of Göttingen, Federal Republic of Germany aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer-Verlag 138/10(1996-10-01), 1193-1199 0001-6268 138:10<1193 1996 138 701 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer