The Effects of Ketamine on Cerebral Circulation and Metabolism in Man

Takeshita, Hiroshi; Okuda, Yoshiaki; Sari, Atuo

doi:10.1097/00000542-197201000-00013

Cited by 236 publications

(109 citation statements)

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“…However, it is also possible that changes in CBF occur secondary to changes in MAP (i.e., impaired cerebrovascular autoregulation). 15,16 The present investigation shows that S(+)-ketamine in combination with low-dose propofol did not alter the dynamic cerebrovascular response to a decrease in MAP. As propofol in concentrations used in the present study does not influence cerebrovascular autoregulation, 9 the present data suggest that S(+)-ketamine does not influence dynamic and static autoregulation.…”

Section: Discussionmentioning

confidence: 47%

“…[12][13][14] This is consistent with studies in awake or N 2 O/O 2 -ventilated animals and humans where racemic ketamine increased CBF along with increases in MAP. 15,16 In contrast, in the presence of anesthetics depressing cerebral metabolism, ketamine did not change or decrease CBF. 1,17,18 This suggests that the effect of ketamine on CBF is related to the pre-existing cerebrovascular tone induced by the background anesthetic technique.…”

Section: Discussionmentioning

confidence: 90%

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S(+)-ketamine/propofol maintain dynamic cerebrovascular autoregulation in humans

Engelhard

Werner

Möllenberg

et al. 2001

Can J Anesth/J Can Anesth

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Section: Discussionmentioning

confidence: 47%

Section: Discussionmentioning

confidence: 90%

S(+)-ketamine/propofol maintain dynamic cerebrovascular autoregulation in humans

Engelhard

Werner

Möllenberg

et al. 2001

Can J Anesth/J Can Anesth

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“…Takeshita, et al reported an increase in CBF with no significant change in CMRo2 in patients free of cardiopulmonat T or neurological complications. 4 However, it is difficult to judge at what point in the study CBF determinations were made in these patients. In our experiments, the maximum effect of ketamine on CBF and CMRo2 occurred approximately five minutes after administration.…”

Section: Discussionmentioning

confidence: 99%

Cerebral blood flow and metabolism following ketamine administration

Schwedler

Miletich

Albrecht

1982

Can. Anaesth. Soc. J.

103

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The effects of ketamine on cerebral blood flow (CBF), cerebral metabolic rate (CMRo2) and intracranial pressure (ICP) were evaluated in ventilated or spontaneously breathing goats after peripheral administration of 5 rag. kg -~ and central administration of 0. 1-2.0 rag.In mechanically ventilated normocarbic goats intravenous ketamine 5 rag-kg -~ had no effect on CBF, but did produce a significant reduction in CMRo2 (4.3 -+ 0.4 vs 3.7 --0.3ml O2.min-I/100g) five minutes after injection. However, in spontaneously breathing goats, ketamine caused a significant increase in CBF (77 ---7 vs 109 -12 ml. min-'ll00g), a significant reduction in CMRo2 (4.3 + 0.3 vs 3.8 -+ 0.4) and an increase of Pco2 from 4.5 -+ 0.5 to 5.4 +-0.9 kPa (34 -4 to 41 -+ 7 torr). Small doses of ketamine (0. I-2.0 rag) injected directly into the cerebral circulation failed to cause any significant change in CBF.Intracranial pressure showed a significant increase from 13 -+ 3 to 19 --3 mm Hg in spontaneously breathing goats and no change in ventilated goats.These data suggest that ketamine is a mild depressant of cerebral metabolic rate and has no other cerebral vascular effects.

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“…ketamine, on CBF. Ketamine has been reported to increase CBF in awake or lightly anesthetized animals and humans (3,4), whereas no changes in CBF (20) or CBF velocity (21,22) were found on ketamine injection when, instead, cerebral depressant anesthetic drugs were used for background anesthesia.…”

Section: Effects Of Confounding Factorsmentioning

confidence: 99%

Racemic ketamine does not abolish cerebrovascular autoregulation in the pig

Schmidt

Ryding

Åkeson

2003

Acta Anaesthesiol Scand

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Background: Little is known about the influence of racemic ketamine on autoregulation of cerebral blood flow (CBF), and available reports regarding its influence on cerebral hemodynamics are contradictory. This study was designed to evaluate cerebrovascular responses to changes in the mean arterial pressure (MAP) during ketamine anesthesia. Methods: In eight normoventilated pigs anesthesia was induced with propofol and maintained by i.v. infusion of ketamine (15.0 mg kg À1 .h À1 ) during measurements. The intra-arterial xenon clearance technique was used to calculate CBF. Balloon-tipped catheters were introduced in the inferior caval vein and mid-aorta, and increases or decreases by up to 40% in mean arterial pressure (MAP) in random order were achieved by titrated inflation of these balloon catheters. Cerebral blood flow was determined at each MAP level. Regression coefficients of linear pressure-flow curves were calculated in all animals. Results: From the mean baseline level (101 mmHg) MAP was reduced by 20% and 40%, and increased by 26% and 43%. The maximal mean increase and decrease in MAP induced a 12% increase and a 15% decrease, respectively, of CBF from the

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The Effects of Ketamine on Cerebral Circulation and Metabolism in Man

Cited by 236 publications

References 0 publications

S(+)-ketamine/propofol maintain dynamic cerebrovascular autoregulation in humans

S(+)-ketamine/propofol maintain dynamic cerebrovascular autoregulation in humans

Cerebral blood flow and metabolism following ketamine administration

Racemic ketamine does not abolish cerebrovascular autoregulation in the pig

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