The acute and residual effects of escalating, analgesic-range doses of ketamine on driving performance: A simulator study.
Prog Neuropsychopharmacol Biol Psychiatry
; 86: 83-88, 2018 08 30.
Article
em En
| MEDLINE
| ID: mdl-29782960
ABSTRACT
Ketamine hydrochloride elicits potent psychotomimetic and neurobehavioural effects which make it incompatible with driving; however, the direct effect on driving performance is yet to be assessed. Using an open label, within-subjects protocol, 15 males and 5 females (mean ageâ¯=â¯30.8â¯years) were administered three fixed, stepwise increasing sub-anaesthetic doses of intravenous (IV) ketamine solution [(i) 8â¯mg/h IV infusion plus 30â¯mg bolus, (ii) 12â¯mg/h IV infusion and (iii) 20â¯mg/h infusion]. Whole blood ketamine and norketamine concentrations were determined at each treatment step and at 2â¯h post-infusion. Driving performance was assessed at baseline, at each treatment step and at 2â¯h post-treatment using a validated computerised driving simulator. Standard Deviation of Lateral Position (SDLP) and Steering Variability (SV) were assessed. Linear Fixed Effect Modelling indicated a main effect for time (dose) for SDLP (F[4,72]â¯=â¯33.22, pâ¯<â¯0.0001) and SV (F[4,72]â¯=â¯4.65, pâ¯<â¯0.002). Post-hoc analyses revealed significant differences from baseline at each treatment step for SDLP (all pâ¯<â¯0.001), and for 12â¯mg/h treatment step for SV (pâ¯=â¯0.049). Post-treatment driving performance returned to baseline levels. Weak positive linear associations were observed between SDLP and whole blood ketamine concentrations (R2â¯=â¯0.11, ßâ¯=â¯29.96, pâ¯=â¯0.001) and norketamine (R2â¯=â¯0.09, ßâ¯=â¯28.87, pâ¯=â¯0.003). These findings suggest that even under highly controlled conditions, ketamine intoxication significantly alters simulated driving performance. At the highest dose, ketamine produced changes to SDLP considered incompatible with safe driving, highlighting how ketamine consumption may translate to an increased risk of road trauma.
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1
Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Guideline
/
Prognostic_studies
Limite:
Adult
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Female
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Humans
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Male
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article