The multiple faces of ketamine in anaesthesia and analgesia

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Abstract

Objective: Ketamine is an anaesthetic agent with a unique dissociative profile and pharmacological effects ranging from the induction and maintenance of anaesthesia to analgesia and sedation, depending on the dose. This article provides information for the clinical use of ketamine in anaesthesia, in both conventional and special circumstances.

Methods: This is a non-systematic review of the literature, through a PubMed search up to February 2021.

Results: With a favourable pharmacokinetic profile, ketamine is used in hospital and prehospital settings for emergency situations. It is suitable for patients with many heart conditions and, unlike other anaesthetics, its potential for cardiorespiratory depression is low. Furthermore, it may be used when venous access is difficult as it may be administered through various routes. Ketamine is the anaesthetic of choice for patients with bronchospasm thanks to its bronchodilatory and anti-inflammatory properties.

Conclusion: With a favourable pharmacokinetic profile, ketamine is used in hospital and prehospital settings for emergency situations and is suitable for patients with many cardiac and respiratory conditions.

Keywords: anaesthesia, dissociative profile, ketamine.

Citation: Natoli S. The multiple faces of ketamine in anaesthesia and analgesia. Drugs in Context 2021; 10: 2020-12-8. DOI: 10.7573/dic.2020-12-8

Contributions: SN searched the literature, evaluated it, and prepared the manuscript. The author meets the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, takes responsibility for the integrity of the work as a whole, and has given her approval for this version to be published.

Disclosure and potential conflicts of interest: In the past 2 years, SN received honoraria for an advisory role for Grunenthal Italia, Sandoz and Angelini Spa; she also received honoraria to participate in a speakers’ bureau for Mylan. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at: https://www.drugsincontext.com/wp-content/uploads/2021/03/dic.2020-12-8-COI.pdf

Acknowledgements: Editorial assistance was provided by Laura Brogelli and Aashni Shah (Polistudium SRL, Milan, Italy). Unconditioned support to this assistance was provided by Minerva Medica and Molteni Farmaceutici.

Funding declaration: Minerva Medica and Molteni Farmaceutici (Firenze, Italy) funded editorial assistance to the article.

Copyright: Copyright © 2021 Natoli S. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0 which allows anyone to copy, distribute, and transmit the article provided it is properly attributed in the manner specified below. No commercial use without permission.

Correct attribution: Copyright © 2021 Natoli S. https://doi.org/10.7573/dic.2020-12-8. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0.

Article URL: https://www.drugsincontext.com/the-multiple-faces-of-ketamine-in-anaesthesia-and-analgesia

Correspondence: Silvia Natoli, Roma Tor Vergata University, Clinical Science and Translational Medicine Department, Via Montpellier 1, 00133 Roma, Italy. Email: silvia.natoli@uniroma2.it

Provenance: Submitted; externally peer reviewed.

Submitted: 17 December 2020; Accepted: 8 March 2021; Publication date: 23 April 2021.

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