Ketamine: Recent evidence and current uses

Abstract

Background: Ketamine is a dissociative anesthetic with a unique pharmacological profile that has garnered increasing interest in recent years due to its potential therapeutic uses. This review provides a comprehensive overview of the recent evidence and current uses of ketamine. The clinical uses of ketamine are summarized, including its approved and off-label uses in various anesthetic and medical conditions. Firstly, ketamine has shown efficacy as an adjunct to general anesthesia, contributing to improved analgesia, hemodynamic stability, and reduced opioid requirements. Additionally, it has demonstrated effectiveness in the management of acute and chronic pain, including postoperative pain, neuropathic pain, and cancer pain. Moreover, ketamine infusion therapy has been explored in the context of enhanced recovery after surgery (ERAS) protocols, where it has shown potential in reducing postoperative opioid consumption and accelerating recovery. The use of ketamine as a sole agent for procedural sedation, particularly in resource-limited settings, has also been investigated, highlighting its safety and efficacy. Furthermore, the emerging role of ketamine in managing opioid-tolerant and opioid-dependent patients in the perioperative period presents an intriguing area of research. The safety and adverse effects of ketamine are reviewed, including its potential cardiovascular, respiratory, and psychological effects. Finally, ongoing research and emerging evidence on ketamine are discussed, including new findings on its mechanisms of action, potential novel clinical applications, and optimization of dosing regimens. In conclusion, the reviewed literature supports the use of ketamine in various clinical settings, while acknowledging the limitations and uncertainties in its use. Continued research, evidence-based practice, and interdisciplinary collaboration are essential to help our understanding of ketamine and its potential clinical applications.