Ketamine infusion

Park, G R; Manara, Alex; Mendel, L.; Bateman, P. E.

doi:10.1111/j.1365-2044.1987.tb05370.x

Cited by 49 publications

(14 citation statements)

References 9 publications

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“…Ketamine, an anesthetic induction agent, is generally reserved for use in patients with severe hypotension or respiratory depression [12]. As we described previously, ketamine (200 and 350 μ M) significantly inhibited platelet activation stimulated by collagen [13].…”

Section: Introductionmentioning

confidence: 99%

Inhibitory Effects of Ketamine on Lipopolysaccharide-Induced Microglial Activation

Chang

Lee

Hsieh

et al. 2009

Mediators of Inflammation

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Microglia activated in response to brain injury release neurotoxic factors including nitric oxide (NO) and proinflammatory cytokines such as tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β). Ketamine, an anesthetic induction agent, is generally reserved for use in patients with severe hypotension or respiratory depression. In this study, we found that ketamine (100 and 250 μM) concentration-dependently inhibited lipopolysaccharide (LPS)-induced NO and IL-1β release in primary cultured microglia. However, ketamine (100 and 250 μM) did not significantly inhibit the LPS-induced TNF-α production in microglia, except at the higher concentration (500 μM). Further study of the molecular mechanisms revealed that ketamine markedly inhibited extracellular signal-regulated kinase (ERK1/2) phosphorylation but not c-Jun N-terminal kinase or p38 mitogen-activated protein kinase stimulated by LPS in microglia. These results suggest that microglial inactivation by ketamine is at least partially due to inhibition of ERK1/2 phosphorylation.

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Section: Introductionmentioning

confidence: 99%

Inhibitory Effects of Ketamine on Lipopolysaccharide-Induced Microglial Activation

Chang

Lee

Hsieh

et al. 2009

Mediators of Inflammation

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“…We excluded another 118 studies based on their full text. We identified three on‐going trials, 27–29 and one trial registration was marked as completed, but we could not identify a publication or full‐text report and the authors did not respond to our inquiries 30 . A total of 34 randomised clinical trials were included.…”

Section: Resultsmentioning

confidence: 99%

Ketamine for postoperative pain treatment in spinal surgery: Systematic review with meta‐analysis and trial sequential analysis

Tornøe

Pind

Laursen

et al. 2023

Acta Anaesthesiol Scand

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AimWe aimed to assess the beneficial and harmful effects of perioperative pain treatment with ketamine in patients undergoing spinal surgery.MethodsWe searched Medline, Embase, and CENTRAL from inception until 15 February 2023 for randomised clinical trials comparing ketamine with placebo or no intervention in patients undergoing spinal surgery. The primary outcomes were cumulative opioid consumption at 24 h postoperatively and serious adverse events. We adhered to recommendations of the Cochrane Collaboration and performed meta‐analysis, Trial Sequential Analysis (TSA) to assess the risks of random errors, risk of bias assessment to evaluate the risks of systematic errors, and used the Grading of Recommendations Assessment, Development and Evaluation (GRADE).ResultsWe included a total of 28 randomised clinical trials enrolling 2110 participants providing data for our pre‐defined outcomes. Twenty‐three trials enrolled adult participants and 5 trials enrolled paediatric participants. Three trials were at low risk of bias. Meta‐analysis and TSA of trials including adults showed that ketamine versus placebo or no intervention seemed to reduce the cumulative 24‐h opioid consumption (mean difference −17.57 mg; TSA‐adjusted 95% confidence interval, −24.22 to −10.92; p < .01; low certainty of evidence), and there was no evidence of a difference of ketamine versus placebo or no intervention on the risk of serious adverse events (risk ratio 2.16; 96.7% confidence interval, 0.35 to 13.17; p = .36; very low certainty of evidence).ConclusionIn adults undergoing spinal surgery, ketamine may reduce cumulative 24‐h opioid consumption. Ketamine may increase the occurrence of serious adverse events, but the evidence was very uncertain.

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“…[34] Continuous infusion of this drug produces better sedation, increase in arterial pressure, and diminution of bronchospasm in critically ill patients. [35]…”

Section: Resultsmentioning

confidence: 99%

Ketamine in status asthmaticus: A review

Goyal

Agarwal

2013

Indian Journal of Critical Care Medicine

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Background and AimsStatus asthmaticus is a common cause of morbidity and mortality. The addition of ketamine to the standard treatment regimen of severe asthma has shown to improve outcome and alleviate the need for mechanical ventilation. The purpose of this review is to determine the pulmonary effects of ketamine and to determine whether sufficient evidence exists to support its use for refractory status asthmaticus.Data Source:MEDLINE, EMBASE, Google Scholar, and Cochrane data bases (from their inception to Jan 2012) using key words “ketamine”, “asthma”, “bronchospasm”, “bronchodilator”, and “mechanical ventilation” were searched to identify the reports on the use of ketamine as a bronchodilator in acute severe asthma or status asthmaticus, and manual review of article bibliographies was done. Relevant databases were searched for the ongoing trials on use of ketamine as a bronchodilator. Outcome measures were analyzed using following clinical questions: Indication, dose and duration of ketamine use, main effects on respiratory mechanics, adverse effects, and mortality.Results:Twenty reports illustrating the use of ketamine as a bronchodilator were identified. In total, 244 patients aged 5 months to 70 years received ketamine for bronchospasm. Twelve case reports, 3 double-blind randomized placebo-controlled trials, 2 prospective observational studies, 2 clinical evaluation study, and 1 retrospective chart review were retrieved. Most of the studies showed improved outcome with use of ketamine in acute severe asthma unresponsive to conventional treatment. Patients who received ketamine improved clinically, had lower oxygen requirements, and obviated the need for invasive ventilation. Mechanically-ventilated patients for severe bronchospasm showed reduction in peak inspiratory pressures, improved gas exchange, dynamic compliance and minute ventilation, and could be weaned off successfully following introduction of ketamine.Conclusion:In various studies, ketamine has been found to be a potential bronchodilator in severe asthma. However, a large prospective clinical trial is warranted before laying down any definitive recommendations on its use in status asthmaticus.

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Ketamine infusion

Abstract: Summary

Cited by 49 publications

References 9 publications

Inhibitory Effects of Ketamine on Lipopolysaccharide-Induced Microglial Activation

Inhibitory Effects of Ketamine on Lipopolysaccharide-Induced Microglial Activation

Ketamine for postoperative pain treatment in spinal surgery: Systematic review with meta‐analysis and trial sequential analysis

Ketamine in status asthmaticus: A review

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