Brands, Medical Use, Clinical Data
- General Anesthetics
Brands / Synonyms
(-)-Ketamine; (S)-(-)-Ketamine; (S)-Ketamine; CI 581 base; CLSTA 20; Esketamine; Ketaject; Ketalar; Ketalar base; Ketamine; Ketamine Base; Ketamine HCL; Ketanest; Ketolar; l-Ketamine
For use as the sole anesthetic agent for diagnostic and surgical procedures that do not require skeletal muscle relaxation.
Ketamine is a rapid-acting general anesthetic producing an anesthetic state characterized by profound analgesia, normal pharyngeal-laryngeal reflexes, normal or slightly enhanced skeletal muscle tone, cardiovascular and respiratory stimulation, and occasionally a transient and minimal respiratory depression. Ketamine is indicated as the sole anesthetic agent for diagnostic and surgical procedures that do not require skeletal muscle relaxation. The anesthetic state produced by Ketamine has been termed “dissociative anesthesia” in that it appears to selectively interrupt association pathways of the brain before producing somesthetic sensory blockade. It may selectively depress the thalamoneocortical system before significantly obtunding the more ancient cerebral centers and pathways (reticularactivating and limbic systems).
Mechanism of Action
Ketamine has several clinically useful properties, including analgesia and less cardiorespiratory depressant effects than other anaesthetic agents, it also causes some stimulation of the cardiocascular system. Ketamine has been reported to produce general as well as local anaesthesia. It interacts with N-methyl-D-aspartate (NMDA) receptors, opioid receptors, monoaminergic receptors, muscarinic receptors and voltage sensitive Ca ion channels. Unlike other general anaesthetic agents, ketamine does not interact with GABA receptors.
Rapidly absorbed following parenteral administration.
Biotrnasformation / Drug Metabolism
Ketamine is contraindicated in those in whom a significant elevation of blood pressure would constitute a serious hazard and in those who have shown hypersensitivity to the drug.
Prolonged recovery time may occur if barbiturates and/or narcotics are used concurrently with ketamine.
Ketamine is clinically compatible with the commonly used general and local anesthetic agents when an adequate respiratory exchange is maintained.