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Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
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Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
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Kubler Ross's Stages of Dying

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Related Experiment Video

Updated: Jun 30, 2026

Intranasal Administration of CNS Therapeutics to Awake Mice
07:15

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Published on: April 8, 2013

Intranasal Ketamine for Existential Distress in Advanced Cancer.

Stefan Aguiar1, Mary Makarious1, Orly Lipsitz1

  • 1University Health Network, University of Toronto (S.A., M.M., O.L., Z.D., R.S.M., G.R., C.Z., E.M., B.H., C.S.Q., A.A.K., Z.P., J.D.R., M.L.), Toronto, Ontario, Canada.

Journal of Pain and Symptom Management
|April 29, 2026
PubMed
Summary
This summary is machine-generated.

Intranasal ketamine significantly improved existential distress and multidimensional symptoms in advanced cancer patients. This palliative care approach offers meaningful relief for psychological and physical suffering.

Keywords:
Intranasal ketaminecancerexistential distresspalliative carepsychological distressquality of life

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Therapeutic Massage for Psychological Well-being in Geriatric Oncology
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Area of Science:

  • Oncology
  • Psychiatry
  • Palliative Care

Background:

  • Advanced cancer patients frequently experience depression and existential distress.
  • Ketamine shows promise as a rapid antidepressant, but its effects on existential distress are less studied.
  • The INKeD-PC trial previously confirmed intranasal ketamine's efficacy for depression in this population.

Purpose of the Study:

  • To report secondary outcomes of the INKeD-PC trial, focusing on existential distress.
  • To evaluate the impact of intranasal ketamine on various psychological and quality of life measures in advanced cancer patients.

Main Methods:

  • Analysis of 15 participants receiving 3 doses of intranasal ketamine.
  • Primary endpoint: Montgomery-Åsberg Depression Rating Scale (MADRS).
  • Secondary endpoints included PHQ-9, GAD-7, ESAS-r, MQOL, and DADDS. Qualitative data supported quantitative findings.

Main Results:

  • Significant improvements were observed across all secondary outcomes, surpassing minimal clinically important differences.
  • Notable improvements in Generalized Anxiety Disorder-7 (GAD-7), Death and Dying Distress Scale (DADDS), ESAS-r, and McGill Quality of Life Questionnaire (MQOL).
  • Psychological symptoms, including existential well-being, showed greater improvement than physical symptoms.

Conclusions:

  • Intranasal ketamine demonstrated clinically meaningful improvements in existential distress for advanced cancer patients.
  • Ketamine may serve as a single agent to address multidimensional distress in palliative care settings.
  • Further research into ketamine's role in managing complex distress in oncology is warranted.