Ketamine as an Anesthetic for Patients with Acute Brain Injury: A Systematic Review.
Neurocrit Care
; 33(1): 273-282, 2020 08.
Article
in En
| MEDLINE
| ID: mdl-32328972
ABSTRACT
For years, the use of ketamine as an anesthetic to patients suffering from acute brain injury has been debated because of its possible deleterious effects on the cerebral circulation and thus on the cerebral perfusion. Early studies suggested that ketamine could increase the intracranial pressure thus lowering the cerebral perfusion and hence reduce the oxygen supply to the injured brain. However, more recent studies are less conclusive and might even indicate that patients with acute brain injury could benefit from ketamine sedation. This systematic review summarizes the evidence regarding the use of ketamine in patients suffering from traumatic brain injury. Databases were searched for studies using ketamine in acute brain injury. Outcomes of interest were mortality, intracranial pressure, cerebral perfusion pressure, blood pressure, heart rate, spreading depolarizations, and neurological function. In total 11 studies were included. The overall level of evidence concerning the use of ketamine in brain injury is low. Only two studies found a small increase in intracranial pressure, while two small studies found decreased levels of intracranial pressure following ketamine administration. We found no evidence of harm during ketamine use in patients suffering from acute brain injury.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Intracranial Pressure
/
Cerebrovascular Circulation
/
Mortality
/
Brain Injuries, Traumatic
/
Ketamine
/
Anesthetics, Dissociative
Type of study:
Prognostic_studies
/
Systematic_reviews
Limits:
Humans
Language:
En
Journal:
Neurocrit Care
Journal subject:
NEUROLOGIA
/
TERAPIA INTENSIVA
Year:
2020
Document type:
Article
Affiliation country:
Denmark