Basic metabolic and vascular effects of ketamine and its interaction with fentanyl

Irwin, Matthew R.; Curay, Carlos M.; Choi, Shinbe; Kiyatkin, Eugene A.

doi:10.1016/j.neuropharm.2023.109465

Cited by 3 publications

(1 citation statement)

References 42 publications

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“…We examined the pattern of brain oxygenation responses induced by iv ketamine (3–27 mg/kg) and its co-administration with fentanyl ( 77 ). To explore the possible mechanisms underlying ketamine-induced brain oxygen responses, we also examined changes in temperature in the brain, temporal muscle, and skin, as well as changes in brain-muscle and skin-muscle differentials: indices that reflect changes in metabolic brain activity and peripheral vascular tone ( 78 ).…”

Section: Interaction Of Heroin and Fentanyl With Other Neuroactive Su...mentioning

confidence: 99%

Brain oxygen responses induced by opioids: focus on heroin, fentanyl, and their adulterants

Kiyatkin,

Choi

2024

Front. Psychiatry

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Opioids are important tools for pain management, but abuse can result in serious health complications. Of these complications, respiratory depression that leads to brain hypoxia is the most dangerous, resulting in coma and death. Although all opioids at large doses induce brain hypoxia, danger is magnified with synthetic opioids such as fentanyl and structurally similar analogs. These drugs are highly potent, act rapidly, and are often not effectively treated by naloxone, the standard of care for opioid-induced respiratory depression. The goal of this review paper is to present and discuss brain oxygen responses induced by opioids, focusing on heroin and fentanyl. In contrast to studying drug-induced changes in respiratory activity, we used chronically implanted oxygen sensors coupled with high-speed amperometry to directly evaluate physiological and drug-induced fluctuations in brain oxygen levels in awake, freely moving rats. First, we provide an overview of brain oxygen responses to physiological stimuli and discuss the mechanisms regulating oxygen entry into brain tissue. Next, we present data on brain oxygen responses induced by heroin and fentanyl and review underlying mechanisms. These data allowed us to compare the effects of these drugs on brain oxygen in terms of their potency, time-dependent response pattern, and potentially lethal effect at high doses. Then, we present the interactive effects of opioids during polysubstance use (alcohol, ketamine, xylazine) on brain oxygenation. Finally, we consider factors that affect the therapeutic potential of naloxone, focusing on dosage, timing of drug delivery, and contamination of opioids by other neuroactive drugs. The latter issue is considered chiefly with respect to xylazine, which strongly potentiates the hypoxic effects of heroin and fentanyl. Although this work was done in rats, the data are human relevant and will aid in addressing the alarming rise in lethality associated with opioid misuse.

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Section: Interaction Of Heroin and Fentanyl With Other Neuroactive Su...mentioning

confidence: 99%

Brain oxygen responses induced by opioids: focus on heroin, fentanyl, and their adulterants

Kiyatkin,

Choi

2024

Front. Psychiatry

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Electroacupuncture attenuates ketamine-induced neuronal injury in the locus coeruleus of rats through modulation of the CAMK II/CREB pathway

Miao

et al. 2023

Brain Research Bulletin

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A study comparing brain wave patterns of fentanyl and ketamine in adult patients undergoing minimally invasive surgery

Wang,

2024

Medicine

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This study aimed to investigate and compare the neurophysiological impacts of two widely used anesthetic agents, Fentanyl and Ketamine, on EEG power spectra during different stages of anesthesia in adult patients undergoing minimally invasive surgery. EEG data were collected from patients undergoing anesthesia with either Fentanyl or Ketamine. The data were analyzed for relative power spectrum and fast-to-slow wave power ratios, alongside Spectral Edge Frequency 95% (SEF95), at 3 key stages: pre-anesthesia, during stable anesthesia, and post-anesthesia. EEG Relative Power Spectrum: Initially, both groups exhibited similar EEG spectral profiles, establishing a uniform baseline (P > .05). Upon anesthesia induction, the Fentanyl group showed a substantial increase in delta band power (P < .05), suggesting deeper anesthesia, while the Ketamine group maintained higher alpha and beta band activity (P < .05), indicative of a lighter sedative effect. Fast and Slow Wave Power Ratios: The Fentanyl group exhibited a marked reduction in the fast-to-slow wave power ratio during anesthesia (P < .05), persisting post-anesthesia (P < .05) and indicating a lingering effect on brain activity. Conversely, the Ketamine group demonstrated a more stable ratio (P > .05), conducive to settings requiring rapid cognitive recovery. Spectral Edge Frequency 95% (SEF95): Analysis showed a significant decrease in SEF95 values for the Fentanyl group during anesthesia (P < .05), reflecting a shift towards lower frequency power. The Ketamine group experienced a less pronounced decrease (P > .05), maintaining a higher SEF95 value that suggested a lighter level of sedation. The study highlighted the distinct impacts of Fentanyl and Ketamine on EEG power spectra, with Fentanyl inducing deeper anesthesia as evidenced by shifts towards lower frequency activity and a significant decrease in SEF95 values. In contrast, Ketamine’s preservation of higher frequency activity and more stable SEF95 values suggests a lighter, more dissociative anesthetic state. These findings emphasize the importance of EEG monitoring in anesthesia for tailoring anesthetic protocols to individual patient needs and optimizing postoperative outcomes.

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Basic metabolic and vascular effects of ketamine and its interaction with fentanyl

Cited by 3 publications

References 42 publications

Brain oxygen responses induced by opioids: focus on heroin, fentanyl, and their adulterants

Brain oxygen responses induced by opioids: focus on heroin, fentanyl, and their adulterants

Electroacupuncture attenuates ketamine-induced neuronal injury in the locus coeruleus of rats through modulation of the CAMK II/CREB pathway

A study comparing brain wave patterns of fentanyl and ketamine in adult patients undergoing minimally invasive surgery

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