Ketamine

Abstract

Summary Ketamine is a very versatile inexpensive drug and plays an invaluable role in the developing world. In regions where access and funding for a wider range of drugs is problematic, its broad range of clinical applications is ideal. Its good safety profile and ease of storage makes it ideal for use in areas where refrigerators, complex monitoring, electricity and oxygen may all be in short supply or unreliable. Ketamine is also finding increasing use in both the acute and chronic pain settings and research is still ongoing into a potential neuroprotective effect for ketamine in brain injury.

Effects of sodium nitroprusside in the prevention of schizophrenia-like symptoms induced by ketamine – A translational double-blind study

“…The same was observed in respect to heart rate. These findings strengthen the cardiovascular safety of the administration of ketamine 14 . During the session with SNP, lower values of SBP and DBP were observed after the bolus of ketamine, as well as a faster recovery from the transient increase in blood pressure compared with the placebo session.…”

Analgesia with Low-Dose S(+)-ketamine in Laparoscopic Cholecystectomy: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial

“…Considering that the duration of dreams is about 5 minutes, coinciding with the plasmatic half-life of S(+)-ketamine [22] it can be hypothesized that bad dream may be associated with high plasma concentrations of this drug. To minimize such occurrence, continuous infusion should be discontinued well before the end of surgery.…”

Anaesthesia in haemodynamically compromised emergency patients: does ketamine represent the best choice of induction agent?

“…Thus there appears huge disparity between the ubiquity of RSI performed daily worldwide, and its (under)representation in the literature. This may be because ketamine is most commonly used in the developing world [48] or in warfare, and these settings are relatively rarely compatible with clinical trials.…”

“…These bodies include the International Committee of the Red Cross and the Finnish Red Cross (who advocate ketamine anaesthesia for both induction and maintenance during surgery in field hospitals [49], Table 2), the West Midlands Ambulance Service and British Association for Immediate Care (who recommend it for non-physician pre-hospital procedural sedation and anaesthesia [51], Table 2), the Italian Comitato Collaborazione Medica (who advocate it for emergency anaesthesia in field hospitals [56], Table 2), and the Motorcycle Union of Ireland Medical Team (MUIMT) who use only ketamine for pre-hospital trauma RSI (personal communication Dr John Hind, Medical Officer MUIMT). When the Association of Anaesthetists of Great Britain and Ireland commissioned a special 'developing world' supplement to Anaesthesia, ketamine featured as the key induction agent in this setting [48].…”