Clinical uses of low-dose ketamine in patients undergoing surgery.
Ketamine acts mainly as a N-methyl-D-aspartate receptor (NMDAr) antagonist. Originally developed as a general anesthetic, it is now seldom employed as such in richer countries due to the relatively high risk of psychotomimetic adverse effects. Recently, low-dose regimens in the range of 0.25-0.5 mg/kg as an initial bolus followed by 50-500 kappag/kg/h have been proposed as an adjuvant for postoperative analgesia and for the reduction of exogenous opioid-induced hyperalgesia. In this review, we examine the evidence for clinical usefulness of perioperative ketamine infusion and its role in the context of general and/or regional anesthesia.
Berti
M
M
Department of Anesthesiology, Critical Care and Pain Medicine, University Hospital of Parma, Parma, Italy. mberti@ao.pr.it
Baciarello
M
M
Troglio
R
R
Fanelli
G
G
D000768:Anesthesia, General; D000772:Anesthesia, Local; D000778:Anesthetics, Dissociative / Q000008:administration & dosage / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D018691:Excitatory Amino Acid Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007649:Ketamine / Q000008:administration & dosage / Q000627:therapeutic use*; D010149:Postoperative Pain / Q000503:physiopathology / Q000517:prevention & control
D000778:Anesthetics, Dissociative; D018691:Excitatory Amino Acid Antagonists; D007649:Ketamine