Ketamine in Acute Abdominal Pain in Patients with Lead Poisoning

Shaghayegh Rahmani; Rana Kolahi Ahari; Hamed Shokoohsaremi; Roohie Farzaneh; Mohammad Davood Sharifi

doi:doi:10.11648/j.cmr.20231201.12

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Ketamine in Acute Abdominal Pain in Patients with Lead Poisoning

Shaghayegh Rahmani, Rana Kolahi Ahari, Hamed Shokoohsaremi, Roohie Farzaneh, Mohammad Davood Sharifi

Published in Clinical Medicine Research (Volume 12, Issue 1)

Received: 21 November 2022 Accepted: 12 January 2023 Published: 28 March 2023

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Abstract

Introduction: In this study, we investigated the effect of intravenous ketamine administration on the treatment of acute abdominal pain in lead poisoning patients. Methods: In this cross sectional study, we evaluated 20 patients with opium abuse with acute abdominal pain. With cardiac monitoring, 0.25 mg/kg ketamine (maximum dose was considered as 20 milligrams) was administered during 30 to 60 seconds. To control ketamine complications 0.03 mg/kg midazolam (maximum dose was considered as 2 milligrams) was injected slowly during one or two minutes. Patients were observed in the ED for the next 6 hours. Pain score was assessed based on VAS with a serial method, before ketamine administration, every hour for the next two hours and every two hours for four hours. Results: In this study 20 patients were enrolled with mean age of 37.2 ± 4.2 years (range from 30 to 44 yrs.). Repeated measurement test shows significant reduce in pain score after ketamine administration (P=0.001). Five patients report no pain 4 hours after ketamine injection, and 3 of them left the hospital with personal consent. From 17 remaining patients, 13 ones (76.4%) had no pain, and mean VAS score in other 4 patients was 1 or 2. Conclusion: our results show that single dose injectable ketamine is one of the best methods with the least side effects to alleviate acute abdominal pain in patients with drug abuse.

Published in	Clinical Medicine Research (Volume 12, Issue 1)
DOI	10.11648/j.cmr.20231201.12
Page(s)	9-12
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Acute Abdominal Pain, Lead Poisoning Patients, Ketamine

References

[1]	Norouzi M, Eskandarion M R, Zargar Y. Death Due to Acute Poisoning with High Dose of Lead in an Opium Addict: A Case Report. Iran J Forensic Med. 2017; 23 (2): 142-146.
[2]	Verheij J, Voortman J, van Nieuwkerk C, Jarbandhan S, Mulder C, Bloemena E. Hepatic Morphopathologic findings of lead poisoning in a drug addict: A case report. J Gastrointestin Liver Dis. 2009; 18 (2): 225-7.
[3]	Pourmand A, Mazer-Amirshahi M, Royall C, Alhawas R, Shesser R. Low dose ketamine use in the emergency department, a new direction in pain management. Am J Emerg Med. 2017 Jun; 35 (6): 918-921. doi: 10.1016/j.ajem.2017.03.005. Epub 2017 Mar 2.
[4]	Sin B, Ternas T, Motov SM. The use of subdissociative-dose ketamine for acute pain in the emergency department. Acad Emerg Med. 2015 Mar; 22 (3): 251-7. doi: 10.1111/acem.12604. Epub 2015 Feb 25.
[5]	Sheikh S, Hendry P. The Expanding Role of Ketamine in the Emergency Department. Drugs. 2018 May; 78 (7): 727-735. doi: 10.1007/s40265-018-0904-8.
[6]	Nichols KA, Paciullo CA. Subdissociative Ketamine Use in the Emergency Department. Adv Emerg Nurs J. 2019 Jan/Mar; 41 (1): 15-22. doi: 10.1097/TME.0000000000000222.
[7]	Salman-Roghani H, Foroozan A. Lead poisoning, report of an interesting case. Govaresh. 2011; 14 (1): 39-46.
[8]	Shariat Moharari R, Khajavi M, Panahkhahi M, Mojtahedzadeh M, Najafi A. Loss of consciousness secondary to lead poisoning. MEJ ANESTH. 2009; 20 (3): 453-6.
[9]	Niesters M, Martini C, Dahan A. Ketamine for chronic pain: risks and benefits. Br J Clin Pharmacol. 2014 Feb; 77 (2): 357-67. doi: 10.1111/bcp.12094.
[10]	Iacobucci GJ, Visnjevac O, Pourafkari L, Nader ND. Ketamine: An Update on Cellular and Subcellular Mechanisms with Implications for Clinical Practice. Pain Physician. 2017 Feb; 20 (2): E285-E301.
[11]	Miracle VA. Lead Poisoning in Children and Adults. Dimens Crit Care Nurs. 2017 Jan/Feb; 36 (1): 71-73.
[12]	Hanna-Attisha M, Lanphear B, Landrigan P. Lead Poisoning in the 21st Century: The Silent Epidemic Continues. Am J Public Health. 2018 Nov; 108 (11): 1430. doi: 10.2105/AJPH.2018.304725.
[13]	Mottier DM, Cargnel E. [Abdominal pain as a presentation by lead poisoning. Case report]. Arch Argent Pediatr. 2017 Apr 1; 115 (2): e96-e98. doi: 10.5546/aap.2017.e96.
[14]	Renfrew D. Lead Poisoning and the Dangers of Pragmatism. Int J Environ Res Public Health. 2018 Sep 13; 15 (9). pii: E1997. doi: 10.3390/ijerph15091997.
[15]	Agency for Toxic Substances and Disease Registry. Interaction profile for chlorpyrifos, lead, mercury, and methylmercury. Atlanta, GA: Agency for Toxic Substances and Disease Registry; 2006. http://www.atsdr.cdc.gov/interactionprofiles/IP-11/ip11.pdf. June 14, 2007.
[16]	Mongolu S, Sharp P. Acute abdominal pain and constipation due to lead poisoning. Acute Med. 2013; 12 (4): 224-6.

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APA Style

Shaghayegh Rahmani, Rana Kolahi Ahari, Hamed Shokoohsaremi, Roohie Farzaneh, Mohammad Davood Sharifi. (2023). Ketamine in Acute Abdominal Pain in Patients with Lead Poisoning. Clinical Medicine Research, 12(1), 9-12. https://doi.org/10.11648/j.cmr.20231201.12

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ACS Style

Shaghayegh Rahmani; Rana Kolahi Ahari; Hamed Shokoohsaremi; Roohie Farzaneh; Mohammad Davood Sharifi. Ketamine in Acute Abdominal Pain in Patients with Lead Poisoning. Clin. Med. Res. 2023, 12(1), 9-12. doi: 10.11648/j.cmr.20231201.12

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AMA Style

Shaghayegh Rahmani, Rana Kolahi Ahari, Hamed Shokoohsaremi, Roohie Farzaneh, Mohammad Davood Sharifi. Ketamine in Acute Abdominal Pain in Patients with Lead Poisoning. Clin Med Res. 2023;12(1):9-12. doi: 10.11648/j.cmr.20231201.12

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@article{10.11648/j.cmr.20231201.12,
  author = {Shaghayegh Rahmani and Rana Kolahi Ahari and Hamed Shokoohsaremi and Roohie Farzaneh and Mohammad Davood Sharifi},
  title = {Ketamine in Acute Abdominal Pain in Patients with Lead Poisoning},
  journal = {Clinical Medicine Research},
  volume = {12},
  number = {1},
  pages = {9-12},
  doi = {10.11648/j.cmr.20231201.12},
  url = {https://doi.org/10.11648/j.cmr.20231201.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20231201.12},
  abstract = {Introduction: In this study, we investigated the effect of intravenous ketamine administration on the treatment of acute abdominal pain in lead poisoning patients. Methods: In this cross sectional study, we evaluated 20 patients with opium abuse with acute abdominal pain. With cardiac monitoring, 0.25 mg/kg ketamine (maximum dose was considered as 20 milligrams) was administered during 30 to 60 seconds. To control ketamine complications 0.03 mg/kg midazolam (maximum dose was considered as 2 milligrams) was injected slowly during one or two minutes. Patients were observed in the ED for the next 6 hours. Pain score was assessed based on VAS with a serial method, before ketamine administration, every hour for the next two hours and every two hours for four hours. Results: In this study 20 patients were enrolled with mean age of 37.2 ± 4.2 years (range from 30 to 44 yrs.). Repeated measurement test shows significant reduce in pain score after ketamine administration (P=0.001). Five patients report no pain 4 hours after ketamine injection, and 3 of them left the hospital with personal consent. From 17 remaining patients, 13 ones (76.4%) had no pain, and mean VAS score in other 4 patients was 1 or 2. Conclusion: our results show that single dose injectable ketamine is one of the best methods with the least side effects to alleviate acute abdominal pain in patients with drug abuse.},
 year = {2023}
}

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TY - JOUR
T1 - Ketamine in Acute Abdominal Pain in Patients with Lead Poisoning
AU - Shaghayegh Rahmani
AU - Rana Kolahi Ahari
AU - Hamed Shokoohsaremi
AU - Roohie Farzaneh
AU - Mohammad Davood Sharifi
Y1 - 2023/03/28
PY - 2023
N1 - https://doi.org/10.11648/j.cmr.20231201.12
DO - 10.11648/j.cmr.20231201.12
T2 - Clinical Medicine Research
JF - Clinical Medicine Research
JO - Clinical Medicine Research
SP - 9
EP - 12
PB - Science Publishing Group
SN - 2326-9057
UR - https://doi.org/10.11648/j.cmr.20231201.12
AB - Introduction: In this study, we investigated the effect of intravenous ketamine administration on the treatment of acute abdominal pain in lead poisoning patients. Methods: In this cross sectional study, we evaluated 20 patients with opium abuse with acute abdominal pain. With cardiac monitoring, 0.25 mg/kg ketamine (maximum dose was considered as 20 milligrams) was administered during 30 to 60 seconds. To control ketamine complications 0.03 mg/kg midazolam (maximum dose was considered as 2 milligrams) was injected slowly during one or two minutes. Patients were observed in the ED for the next 6 hours. Pain score was assessed based on VAS with a serial method, before ketamine administration, every hour for the next two hours and every two hours for four hours. Results: In this study 20 patients were enrolled with mean age of 37.2 ± 4.2 years (range from 30 to 44 yrs.). Repeated measurement test shows significant reduce in pain score after ketamine administration (P=0.001). Five patients report no pain 4 hours after ketamine injection, and 3 of them left the hospital with personal consent. From 17 remaining patients, 13 ones (76.4%) had no pain, and mean VAS score in other 4 patients was 1 or 2. Conclusion: our results show that single dose injectable ketamine is one of the best methods with the least side effects to alleviate acute abdominal pain in patients with drug abuse.
VL - 12
IS - 1
ER -

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Author Information

Shaghayegh Rahmani

Clinical Research Development Center, 22 Behman Hospital, Faculty of Medicine, Mashhad Medical Sciences, Islamic Azad University, Mashhad, Iran
Rana Kolahi Ahari

Faculty of Medicine, Mashhad Branch, Islamic Azad University, Mashhad, Iran
Hamed Shokoohsaremi

Emergency Department, Mashhad University of Medical Sciences, Mashhad, Iran
Roohie Farzaneh

Emergency Department, Mashhad University of Medical Sciences, Mashhad, Iran
Mohammad Davood Sharifi

Emergency Department, Mashhad University of Medical Sciences, Mashhad, Iran

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APA Style

Shaghayegh Rahmani, Rana Kolahi Ahari, Hamed Shokoohsaremi, Roohie Farzaneh, Mohammad Davood Sharifi. (2023). Ketamine in Acute Abdominal Pain in Patients with Lead Poisoning. Clinical Medicine Research, 12(1), 9-12. https://doi.org/10.11648/j.cmr.20231201.12

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ACS Style

Shaghayegh Rahmani; Rana Kolahi Ahari; Hamed Shokoohsaremi; Roohie Farzaneh; Mohammad Davood Sharifi. Ketamine in Acute Abdominal Pain in Patients with Lead Poisoning. Clin. Med. Res. 2023, 12(1), 9-12. doi: 10.11648/j.cmr.20231201.12

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AMA Style

Shaghayegh Rahmani, Rana Kolahi Ahari, Hamed Shokoohsaremi, Roohie Farzaneh, Mohammad Davood Sharifi. Ketamine in Acute Abdominal Pain in Patients with Lead Poisoning. Clin Med Res. 2023;12(1):9-12. doi: 10.11648/j.cmr.20231201.12

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@article{10.11648/j.cmr.20231201.12,
  author = {Shaghayegh Rahmani and Rana Kolahi Ahari and Hamed Shokoohsaremi and Roohie Farzaneh and Mohammad Davood Sharifi},
  title = {Ketamine in Acute Abdominal Pain in Patients with Lead Poisoning},
  journal = {Clinical Medicine Research},
  volume = {12},
  number = {1},
  pages = {9-12},
  doi = {10.11648/j.cmr.20231201.12},
  url = {https://doi.org/10.11648/j.cmr.20231201.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20231201.12},
  abstract = {Introduction: In this study, we investigated the effect of intravenous ketamine administration on the treatment of acute abdominal pain in lead poisoning patients. Methods: In this cross sectional study, we evaluated 20 patients with opium abuse with acute abdominal pain. With cardiac monitoring, 0.25 mg/kg ketamine (maximum dose was considered as 20 milligrams) was administered during 30 to 60 seconds. To control ketamine complications 0.03 mg/kg midazolam (maximum dose was considered as 2 milligrams) was injected slowly during one or two minutes. Patients were observed in the ED for the next 6 hours. Pain score was assessed based on VAS with a serial method, before ketamine administration, every hour for the next two hours and every two hours for four hours. Results: In this study 20 patients were enrolled with mean age of 37.2 ± 4.2 years (range from 30 to 44 yrs.). Repeated measurement test shows significant reduce in pain score after ketamine administration (P=0.001). Five patients report no pain 4 hours after ketamine injection, and 3 of them left the hospital with personal consent. From 17 remaining patients, 13 ones (76.4%) had no pain, and mean VAS score in other 4 patients was 1 or 2. Conclusion: our results show that single dose injectable ketamine is one of the best methods with the least side effects to alleviate acute abdominal pain in patients with drug abuse.},
 year = {2023}
}

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