Revising a Dogma: Ketamine for Patients with Neurological Injury?

Himmelseher, Sabine; Durieux, Marcel E.

doi:10.1213/01.ane.0000160585.43587.5b

Cited by 261 publications

(142 citation statements)

References 97 publications

Supporting

Mentioning

137

Contrasting

Unclassified

Order By: Relevance

“…Ketamine is a parenteral anesthetic that non-competitively blocks the NMDA receptor [9] . It has been shown that ketamine protects various tissues from I/R injury, such as brain [10] , myocardium [11] and skeletal muscle [12] . To the best of our knowledge, no previous studies have evaluated the effects of ketamine on intestinal motility impairment and tissue damage induced by I/R.…”

Section: Introductionmentioning

confidence: 99%

Ketamine anesthesia reduces intestinal ischemia/reperfusion injury in rats

Cámara¹,

Guzmán²,

Barrera³

et al. 2008

WJG

View full text Add to dashboard Cite

showed significantly less injury in rats that received ketamine than in rats that did not (2.35 ± 1.14 vs 4.58 ± 0.50, P < 0.0001). The distance traveled by a marker, expressed as percentage of total intestinal length, in rats that received pentobarbital sodium was 20% ± 2% in comparison with 25.9% ± 1.64% in rats that received ketamine (P = 0.017 INTRODUCTIONMesenteric ischemia is a clinical entity with a mortality rate between 60% and 100% that usually requires surgical resection of the necrotic intestinal segment [1] . Although there have been advancements in the treatment of ischemic injury, an ideal treatment has not been defined, and new options should be considered. A promising strategy is the use of anesthetic and sedative agents that might exert protective effects on the injured tissue. Ketamine is an agent that has been recommended for this purpose in clinical situations of sepsis, renal ischemia, cerebral ischemia and serious burn injuries [2][3][4] . The small intestine is very sensitive to ischemic insult [5] . Reperfusion causes additional damage through the release of free radicals, pro-inflammatory cytokines, leukotrienes and other related products [6] . Intestinal Abstract AIM: To investigate the effects of ketamine anesthesia on the motility alterations and tissue injury caused by ischemia/reperfusion in rats. METHODS: T h i r ty m a l e W i s t a r ra t s w e i g h i n g 200-250 g were used. Ischemia was induced by obstructing blood flow in 25% of the total small intestinal length (ileum) with a vascular clamp for 45 min, after which either 60 min or 24 h of reperfusion was allowed. Rats were either anesthetized with pentobarbital sodium (50 mg/kg) or ketamine (100 mg/kg). Control groups received sham surgery. After 60 min of reperfusion, the intestine was examined for morphological alterations, and after 24 h intestinal basic electrical rhythm (BER) frequency was calculated, and intestinal transit determined in all groups. RESULTS: The intestinal mucosa in rats that were anesthetized with ketamine showed moderate alterations such as epithelial lifting, while ulceration and hemorrhage was observed in rats that received pentobarbital sodium after 60 min of reperfusion. Quantitative analysis of structural damage using the Chiu scale

show abstract

Section: Introductionmentioning

confidence: 99%

Ketamine anesthesia reduces intestinal ischemia/reperfusion injury in rats

Cámara¹,

Guzmán²,

Barrera³

et al. 2008

WJG

View full text Add to dashboard Cite

show abstract

“…Under appropriate sedation with controlled ventilation conditions, ketamine does not increase ICP, however, when given at 2 mg/kg or above in awake children and adults, it increases ICP and, especially, if there is high ICP this increase is more pronounced. These patients have effective respiration as ETCO 2 and arterial CO2 do not increase and it is stated that nearly all have obstructed ventricular system (due to no shunt or shunt not working) (4)(5)(6)(7)(8).…”

Section: Discussionmentioning

confidence: 99%

Ketamine Sedation of Case with Unknown Posterior Fossa Tumor

Aydın¹,

Akın²,

Küçükosman³

et al. 2016

Haseki

View full text Add to dashboard Cite

Ketamine, chosen for many years for anesthetic practice, is the only agent with analgesic, hypnotic and amnesic effects. Since the use of ketamine may cause uncontrolled increases in intracranial pressure, in the literature, there are concerns about its use, especially for patients with increased intracranial pressure. In this article, we aimed to present the case of a patient with an unknown posterior fossa tumor who did not recover after ketamine administered for sedation. Keywords: Ketamine, sedation, intracranial massAnestezi pratiğinde uzun yıllardan beri tercih edilmekte olan ketamin, analjezik, hipnotik ve amnezik etkileri olan tek ajandır. Literatürde ketamin kullanımının kontrol edilemeyen kafa içi basınç artışlarına yol açması nedeniyle özellikle artmış kafa içi basıncı olan hastalarda kullanımı ile ilgili endişeler mevcuttur. Yazımızda posterior fossa tümörü olduğu bilinmeyen, sedasyonu için ketamin uygulanması sonucu derlenemeyen olgunun sunulması amaçlanmıştır.

show abstract

“…Initial early ketamine literature did report an increase intracranial pressure (47). A more recent literature review challenges these early reports and suggests a possible neuroprotective role for ketamine (55).…”

Section: Ketaminementioning

confidence: 99%

Induction Agents for Endotracheal Intubation in Severe Sepsis and Septic Shock

Mullen¹

2012

Sepsis - An Ongoing and Significant Challenge

View full text Add to dashboard Cite

Revising a Dogma: Ketamine for Patients with Neurological Injury?

Cited by 261 publications

References 97 publications

Ketamine anesthesia reduces intestinal ischemia/reperfusion injury in rats

Ketamine anesthesia reduces intestinal ischemia/reperfusion injury in rats

Ketamine Sedation of Case with Unknown Posterior Fossa Tumor

Induction Agents for Endotracheal Intubation in Severe Sepsis and Septic Shock

Contact Info

Product

Resources

About