Ketamine, a general anaesthetic agent and more. A review on its use in and out the clinical setting

Öri, C.; Dalsasso, M.; Freo, Ulderico

doi:10.1007/978-88-470-2189-1_17

Cited by 2 publications

(3 citation statements)

References 67 publications

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“…Obesity is associated with higher rates of chronic pain and higher scores of post-operative pain, which are both challenging to treat in this patient population (Belcaid and Eipe, 2019;Mills et al, 2019). As opioids may induce ventilatory impairment, multimodal opioid-and muscle relaxant-sparing techniques are being investigated to improve the safety of analgesia in obese patients; in this regard, KET may present specific advantages (Ori et al, 2003;Dalsasso et al, 2005;Freo et al, 2011;Carron et al, 2012;García-Henares et al, 2018;Aronsohn et al, 2019).…”

Section: Effects Of Ket On Post-operative Painmentioning

confidence: 99%

Neuromodulatory Interventions for Pain

2022

Frontiers Research Topics

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Section: Effects Of Ket On Post-operative Painmentioning

confidence: 99%

Neuromodulatory Interventions for Pain

2022

Frontiers Research Topics

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“…Almost unique among general anesthetics, the NMDA antagonist KET has anesthetic properties with low cardiovascular and respiratory depression ( Cohen et al, 2018 ). KET is also clinically attractive because it has strong analgesic and antidepressant activities and may prevent central sensitization and hyperalgesia ( Freo and Ori, 2003 ; Ori et al, 2003 ; García-Henares et al, 2018 ). Hence, KET is of interest for patients prone to anesthesia-induced respiratory impairment or suffering from chronic pain and/or depression or, more, for patients presenting with all these clinical features such as the morbidly obese ( Freo and Ori, 2003 ; Ori et al, 2003 ; Carron et al, 2012 ; García-Henares et al, 2018 ).…”

Section: Clinical Studiesmentioning

confidence: 99%

“…Obesity is associated with higher rates of chronic pain and higher scores of post-operative pain, which are both challenging to treat in this patient population ( Belcaid and Eipe, 2019 ; Mills et al, 2019 ). As opioids may induce ventilatory impairment, multimodal opioid- and muscle relaxant-sparing techniques are being investigated to improve the safety of analgesia in obese patients; in this regard, KET may present specific advantages ( Ori et al, 2003 ; Dalsasso et al, 2005 ; Freo et al, 2011 ; Carron et al, 2012 ; García-Henares et al, 2018 ; Aronsohn et al, 2019 ).…”

Section: Clinical Studiesmentioning

confidence: 99%

Analgesic and Antidepressant Effects of the Clinical Glutamate Modulators Acetyl-L-Carnitine and Ketamine

et al. 2021

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Pain and depression are leading causes of disability and of profound social and economic burden. Their impact is aggravated by their chronicity and comorbidity and the insufficient efficacy of current treatments. Morphological and functional metabolism studies link chronic pain and depressive disorders to dysfunctional neuroplastic changes in fronto-limbic brain regions that control emotional responses to painful injuries and stressful events. Glutamate modulators are emerging new therapies targeting dysfunctional brain areas implicated in the generation and maintenance of chronic pain and depression. Here, we report the effects of two clinically approved glutamate modulators: acetyl-L-carnitine (ALCAR) and S, R(±)ketamine (KET). ALCAR is a natural neurotrophic compound currently marketed for the treatment of neuropathies. KET is the prototypical non-competitive antagonist at N-methyl-D-aspartate glutamate receptors and a clinically approved anesthetic. Although they differ in pharmacological profiles, ALCAR and KET both modulate aminergic and glutamatergic neurotransmissions and pain and mood. We assessed in rats the effects of ALCAR and KET on cerebral metabolic rates for glucose (rCMRglc) and assessed clinically the effects of ALCAR in chronic pain and of KET in post-operative pain. ALCAR and KET increased rCMRglc at similar degrees in prefrontal, somatosensory, and cingulate cortices, and KET increased rCMRglc at a different, much larger, degree in limbic and dopaminergic areas. While rCMRglc increases in prefrontal cortical areas have been associated with analgesic and antidepressant effects of ALCAR and KET, the marked metabolic increases KET induces in limbic and dopaminergic areas have been related to its psychotomimetic and abuse properties. In patients with chronic neuropathic pain, ALCAR (1,000 mg/day) yielded to a fast (2 weeks) improvement of mood and then of pain and quality of life. In day-surgery patients, KET improved dischargeability and satisfaction. In obese patients undergoing bariatric surgery, a single, low dose of KET (0.5 mg/kg) at induction of anesthesia determined a very fast (hours) amelioration of post-operative depression and pain and an opioid-sparing effect. These findings indicate that ALCAR and KET, two non-selective glutamate modulators, still offer viable therapeutic options in comorbid pain and depression.

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Ketamine, a general anaesthetic agent and more. A review on its use in and out the clinical setting

Cited by 2 publications

References 67 publications

Neuromodulatory Interventions for Pain

Neuromodulatory Interventions for Pain

Analgesic and Antidepressant Effects of the Clinical Glutamate Modulators Acetyl-L-Carnitine and Ketamine

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