Ketamine: a controversial drug for neonates.
Ketamine is widely used for anesthesia and analgesia in neonates and children. It provides potent sedation, analgesia, and amnesia, a short duration of action, supporting hemodynamic and respiratory stability. Noncompetitive antagonism of NMDA receptors produces its primary therapeutic effects, but it also alters receptor function at dopaminergic, serotonergic, cholinergic, and opioidergic sites. Recent interest in ketamine stems from its potential to block excitotoxic cell death, although concerns have been raised about anesthetic neurotoxicity in neonatal animal models. The development of ketamine, its clinical profile, toxic effects in the immature brain, and future applications in neonates and children are reviewed in this article.
Bhutta
Adnan T
AT
Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR 72202, USA. bhuttaadnant@uams.edu
D000778:Anesthetics, Dissociative / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007649:Ketamine / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D010146:Pain / Q000188:drug therapy*; D016194:Receptors, N-Methyl-D-Aspartate / Q000187:drug effects
D000778:Anesthetics, Dissociative; D016194:Receptors, N-Methyl-D-Aspartate; D007649:Ketamine