Comparison of Ketamine and Thiopental in Healthy Volunteers

Moretti, Robert J.; Hassan, Shakeela Z.; Goodman, Lowell I.; Meltzer, Herbert Y.

doi:10.1213/00000539-198412000-00007

Cited by 52 publications

(18 citation statements)

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“…Some studies even suggest that dreams and hallucinations attributed to ketamine may instead be illusions produced by a fluctuating level of consciousness during a prolonged emergence after ketamine administration (20). When used in lower doses (<2 mg/kg) and in combination with other drugs (barbiturate, benzodiazepine, or N 2 0 among others), the incidence of these phenomena is low and similar to that observed with general anesthetic techniques without ketamine (21).…”

Section: Discussionmentioning

confidence: 94%

Wakefulness during Cesarean Section after Anesthetic Induction with Ketamine, Thiopental, or Ketamine and Thiopental Combined

Schultetus

Hill

Dharamraj

et al. 1986

Anesthesia & Analgesia

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SCHULTETUS RR, HILL CR, DHARAMRAJ CM, BANNER TE, BERMAN LS. Wakefulness during cesarean section after anesthetic induction with ketamine, thiopental, or ketamine and thiopental combined. Anesth Analg 1986;65:723-8.Thirty-six pregnant women ( A S A class 1 or 11) at term who underwent general anesthesia and cesarean section received either ketamine, 1 mglkg ( n = 12); thiopental, 4 mglkg ( n = 13); or a combination of ketamine, 0.5 mglkg, and thiopental, 2 mglkg ( n = 11). A blood pressure cuff inflated to 250 mm Hg isolated one arm from the effects of succinylcholine so that awareness during anesthesia could be assessed by asking the patient to move her hand. Although only one patient receiving ketamine responded to commands during anesthesia, 46% of patients receiving either thiopental or the combination responded to commands intraoperatively. No patient hallucinated, the incidence of dreams was low (11%), and no postoperative dysphoria was noted. Three patients (8%) had postoperative recall of intraoperative awareness; one had received thiopental and two the combination. Maternal intraoperative cardiovascular responses among the groups were similar, as were umbilical blood gas values, newborn Apgar scores, and neonatal neurobehavioral test scores at 4 and 24 hr. Ketamine more effectively blocked maternal responsiveness to commands and strong stimuli during the first few minutes after anesthetic induction for cesarean section than did thiopental or a combination of thiopenfal and ketamine, each at a lower dose.

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Section: Discussionmentioning

confidence: 94%

Wakefulness during Cesarean Section after Anesthetic Induction with Ketamine, Thiopental, or Ketamine and Thiopental Combined

Schultetus

Hill

Dharamraj

et al. 1986

Anesthesia & Analgesia

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“…First, it demonstrates that stimulation of the PCP receptor can have long lasting effects in the hippocampus both at the NMDA receptor and at the KA site. These and associated changes may underlie some of the extended behavioral actions of PCP in humans like "flashbacks" and reactivated psychosis (Moretti et al, 1984;Lahti et al, 1994). These results also raise the probability that physiologic functioning of the glutamate system in the hippocampus may be temporally as well as pharmacologically complex.…”

Section: Discussionmentioning

confidence: 96%

MK801 induces late regional increases in NMDA and kainate receptor binding in rat brain

Gao

Tamminga

1995

J. Neural Transmission

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We have previously shown that a single dose of PCP produces a dose-related increase in NMDA-sensitive 3H-glutamate binding in CA1 of hippocampus 24 hours later, and some regional changes in kainate binding. Here we report that dizocilpine (MK 801) (0.1 mg/kg and 1 mg/kg), a selective agonist at the PCP receptor and a noncompetitive antagonist of NMDA, produces a similar increase in NMDA-sensitive glutamate and kainate receptor binding in hippocampus 24 hours after a dose. These observations support the conclusion that blockade of glutamate-mediated transmission at the NMDA receptor selectively increases NMDA-sensitive glutamate receptor binding in CA1 of hippocampus and kainate binding in CA3 and dentate gyrus at putatively delayed time points. Several additional areas outside of hippocampus also showed receptor changes at 24 hours after MK801.

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“…In subanesthetic doses, ketamine produces depersonalization; it also induces a schizophrenic-like psychosis and has welldescribed effects on cognition [Adler et al, 1998;Krystal et al, 1994;Malhotra et al, 1996]. Its behavioral effects remit soon after administration [Moretti et al, 1984;Pandit et al, 1980] and clinically it is very safe to use, producing little respiratory effect and transient cardiovascular effects.…”

Section: Introductionmentioning

confidence: 99%

Ketamine and fMRI BOLD signal: Distinguishing between effects mediated by change in blood flow versus change in cognitive state

Abel¹,

Allin²,

Kucharska-Pietura

et al. 2002

Human Brain Mapping

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No human fMRI studies have examined ketamine effects on the BOLD signal change associated with cognitive task performance. We wished to distinguish between effects on 1) cerebral blood flow, with resultant change in BOLD signal; and 2) cognition and neural mechanisms underlying BOLD signal change associated with task performance. Eight right-handed men (mean age 28.75 years) received ketamine or saline i.v. in a randomized, double-blind manner (bolus 0.23 mg/kg; 0.5 mg/kg over 45 min to a maximum 1 hr). Subjects viewed 10 alternating 30-sec blocks of faces with neutral expressions and a fixation cross and discriminated gender of faces. Gradient echo echoplanar images were acquired on a GE Signa 1.5 T Neurovascular system. One hundred T2-weighted images depicting BOLD contrast were acquired over 5 min (for each task) at each of 14 near-axial noncontiguous 7-mm thick planes. Ketamine significantly increased dissociative phenomena and negative symptoms, but did not affect performance of the gender discrimination task. Significant BOLD signal change was demonstrated predominantly in occipitotemporal cortex with both ketamine and placebo. Only two clusters in middle occipital gyrus (BA 18) and precentral gyrus (BA 4) showed significantly decreased BOLD signal change during ketamine compared to placebo. BOLD signal change was not significantly greater in any region during ketamine. Our findings demonstrate subtle rather than major differences between the effects of ketamine and placebo upon the BOLD signal change during perception of face-non face contrast. We suggest that they represent task-dependent effects of the drug/placebo, rather than task-independent effects of the drug per se, and indicate that the effects of ketamine on cerebral blood flow are predominantly focal and task-dependent, rather than global and task-independent.

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Comparison of Ketamine and Thiopental in Healthy Volunteers

Cited by 52 publications

References 0 publications

Wakefulness during Cesarean Section after Anesthetic Induction with Ketamine, Thiopental, or Ketamine and Thiopental Combined

Wakefulness during Cesarean Section after Anesthetic Induction with Ketamine, Thiopental, or Ketamine and Thiopental Combined

MK801 induces late regional increases in NMDA and kainate receptor binding in rat brain

Ketamine and fMRI BOLD signal: Distinguishing between effects mediated by change in blood flow versus change in cognitive state

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