Re-evaluation of the applicability of ketamine in neurosurgical anesthesia
Anesthesia and Pain Medicine
; : 231-236, 2014.
Article
in Ko
| WPRIM
| ID: wpr-192650
Responsible library:
WPRO
ABSTRACT
Traditionally, Ketamine has been considered to be contraindicated in neurosurgical patients due to the risk of intracranial hypertension. The evidence for this contraindication originated from early case reports and case-control studies which were inadequately designed and controlled. However, several recent articles indicate that ketamine can be safely used in traumatic brain injured patients treated with mechanical ventilation and that there is no significant increase in the intracranial pressure (ICP). Ketamine is an N-methyl-D-aspartate antagonist. It is believed to provide neuroprotection through a reduction in the glutamate excitotoxicity. This evidence is based on in vitro and animal studies. However, studies about its neuroprotective effects in humans are scarce. Data to recommend ketamine as first-line anesthetics for neurosurgery are insufficient, but ketamine as an adjuvant anesthetic agent may have benefits for neurosurgical patients, such as traumatic head injured patients with unstable hemodynamics. Therefore, ketamine should not be considered as absolutely contraindicated for neurosurgical patients and adequately powered, high-quality randomized controlled studies are needed to provide clinical evidences.
Key words
Full text:
1
Index:
WPRIM
Main subject:
Respiration, Artificial
/
Brain
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Brain Injuries
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Intracranial Pressure
/
Case-Control Studies
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N-Methylaspartate
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Neuroprotective Agents
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Glutamic Acid
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Intracranial Hypertension
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Head
Type of study:
Clinical_trials
/
Observational_studies
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Risk_factors_studies
Limits:
Animals
/
Humans
Language:
Ko
Journal:
Anesthesia and Pain Medicine
Year:
2014
Type:
Article