Ketamine Revisited - New Insights into NMDA Inhibitors [Working Title]最新文献

Ketamine for Non-Neuropathic Pain 氯胺酮治疗非神经性疼痛

Ketamine Revisited - New Insights into NMDA Inhibitors [Working Title] Pub Date : 2021-12-26 DOI: 10.5772/intechopen.101665

Subbulakshmi Sundaram, Ashok Swaminathan Govindarajan

{"title":"Ketamine for Non-Neuropathic Pain","authors":"Subbulakshmi Sundaram, Ashok Swaminathan Govindarajan","doi":"10.5772/intechopen.101665","DOIUrl":"https://doi.org/10.5772/intechopen.101665","url":null,"abstract":"Chronic pain is one of the leading causes of years lost to disability, as most of the time it is refractory to conventional treatment. Recent advances in understanding the pain mechanisms have favored the use of ketamine as a rescue agent in refractory chronic pain conditions, as it has potential modulating effect on both sensory-discriminative and affective motivational components of pain. Preclinical studies also suggested the antinociceptive effect of sub anesthetic dose of ketamine against central and peripheral neuropathic pain conditions and non-neuropathic pain conditions such as inflammatory and nociceptive pain states. Subanesthetic infusion of ketamine along with adjuvants such as midazolam and clonidine is found to reduce the psychomimetic and cardiovascular side effects of ketamine. Even though the consensus guidelines for intravenous use of ketamine for chronic pain advocate the use of ketamine only for complex regional pain syndrome, various other clinical studies suggested its role in other refractory painful conditions. Hence the present topic focuses specifically on the effect of ketamine on non-neuropathic pain conditions such as complex regional pain syndrome, fibromyalgia, headache, ischemic limb pain, etc. Many studies had shown that ketamine not only reduces the pain scores but also the analgesic medications, which further improves the well-being and quality of life.","PeriodicalId":134765,"journal":{"name":"Ketamine Revisited - New Insights into NMDA Inhibitors [Working Title]","volume":"308 5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132924832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ketamine Anesthesia in Electroconvulsive Therapy 氯胺酮麻醉在电休克治疗中的应用

Ketamine Revisited - New Insights into NMDA Inhibitors [Working Title] Pub Date : 2021-11-18 DOI: 10.5772/intechopen.101365

M. Satomoto

引用次数: 0

Ketamine: More than Just NMDA Blocker 氯胺酮:不仅仅是NMDA阻滞剂

Ketamine Revisited - New Insights into NMDA Inhibitors [Working Title] Pub Date : 2021-11-03 DOI: 10.5772/intechopen.101113

Bhargab Deka, B. Dash, Alakesh Bharali, Ashique Ahmed

{"title":"Ketamine: More than Just NMDA Blocker","authors":"Bhargab Deka, B. Dash, Alakesh Bharali, Ashique Ahmed","doi":"10.5772/intechopen.101113","DOIUrl":"https://doi.org/10.5772/intechopen.101113","url":null,"abstract":"Ketamine has been extensively used in the medical field for more than 50 years, but its exact mechanism of action remains unknown. It's used to induce dissociative anesthesia (a state of profound analgesia, amnesia with light sleep, immobility, and a sense of disassociation from one's own body and surroundings). Clinical studies on ketamine as a dissociative anesthetic, a model for psychosis, and as a rapidly acting antidepressant have sparked great interest in understanding its effects at the molecular and cellular level. It exerts uncompetitive inhibitory effects on NMDARs (N-Methyl-D-asperate) and may preferentially affect the function of NMDARs in interneurons. The hypnotic effects of this drug are attributed to its blocking action on NMDA and HCN1 receptors; however, both positive and negative modulation of choline, amine, and opioid systems appears to occur. It is likely that ketamine's effect on chronic pain and depression far outlasts its actual levels. This could be due to the hyperglutamatergic state induced by ketamine causing a secondary increase in structural synaptic connectivity. The authors of this review have attempted to highlight the action of ketamine not only on NMDA receptors but also on a variety of biochemical processes and functions found in intercellular environments, which may explain its diverse role in many diseases.","PeriodicalId":134765,"journal":{"name":"Ketamine Revisited - New Insights into NMDA Inhibitors [Working Title]","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124188788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Perspective Chapter - NMDA Treatments for CNS Disorders 展望章- NMDA治疗中枢神经系统疾病

Ketamine Revisited - New Insights into NMDA Inhibitors [Working Title] Pub Date : 2021-10-28 DOI: 10.5772/intechopen.100528

Chih-Hung Lin, Po-Chang Shih, Guochuan Emil Tsai

引用次数: 0

Low-Dose Ketamine for Acute Postoperative Pain Treatment 小剂量氯胺酮治疗急性术后疼痛

Ketamine Revisited - New Insights into NMDA Inhibitors [Working Title] Pub Date : 2021-10-21 DOI: 10.5772/intechopen.100415

A. Gelmanas, Miglė Vitartaitė, R. Tamošiūnas, A. Macas

{"title":"Low-Dose Ketamine for Acute Postoperative Pain Treatment","authors":"A. Gelmanas, Miglė Vitartaitė, R. Tamošiūnas, A. Macas","doi":"10.5772/intechopen.100415","DOIUrl":"https://doi.org/10.5772/intechopen.100415","url":null,"abstract":"Treatment of acute postoperative pain is an essential part of perioperative care and if left untreated could complicate the healing period. Ketamine blocks nociceptive pain and pain arising from inflammation. Therefore, it is potentially beneficial in the postoperative period. After systematic review using “MEDLINE/PubMed (NLM)” database, we analyzed 18 studies published during 2011–2020 and found that 0.5 mg/kg/h ketamine bolus and 0.1–0.25 mg/kg/h ketamine infusion to be the most effective dose to alleviate postoperative acute pain. Ketamine, when compared with a placebo, did not have any impact on patients’ satisfaction with postoperative pain management and overall well-being. Only three studies revealed more frequent adverse reactions to ketamine after surgery suggesting that ketamine did not have any impact on patients’ postoperational rehabilitation. So, it is the option to recommend low-dose ketamine to be part of multimodal analgesia in acute severe postoperative pain treatment. It can be used in both opioid-dependent and opioid-tolerant patients. Ketamine bolus should be ≤0.35 mg/kg and infusion ≤1 mg/kg/h. One should avoid the use of ketamine in pregnant women, people with cardiovascular diseases, acute psychosis, impaired liver function, increased intracranial, and intraocular pressure. Intranasal ketamine may be considered for children during procedures outside of the operation room.","PeriodicalId":134765,"journal":{"name":"Ketamine Revisited - New Insights into NMDA Inhibitors [Working Title]","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133906808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Application of Ketamine in Current Practice of Anesthesiology 氯胺酮在当前麻醉学实践中的应用

Ketamine Revisited - New Insights into NMDA Inhibitors [Working Title] Pub Date : 2021-10-20 DOI: 10.5772/intechopen.100461

Shridevi Pandya Shah, Devanshi Patel, Antony Irungu

引用次数: 0

An Update of Ketamine Illicit Use 非法使用氯胺酮的最新情况

Ketamine Revisited - New Insights into NMDA Inhibitors [Working Title] Pub Date : 2021-10-20 DOI: 10.5772/intechopen.100644

P. Kleczkowska, M. Zaremba

{"title":"An Update of Ketamine Illicit Use","authors":"P. Kleczkowska, M. Zaremba","doi":"10.5772/intechopen.100644","DOIUrl":"https://doi.org/10.5772/intechopen.100644","url":null,"abstract":"Ketamine is a derivative of phencyclidine with unique anesthetic, analgesic, as well as antidepressant pharmacological properties. Despite its clinical use, ketamine is classified on the list with new psychoactive substances having psychedelic properties. The abuse trend of ketamine increasing globally, and it became a common club drug over the past few decades. Of note, recreational use of ketamine may pose a threat to public health, leading to numerous physical, as well as psychiatric negative effects. In addition, simultaneously or sequentially ketamine use with other drugs, resulting in serious health consequences. Currently, there are no specific treatment options for managing compulsive drug-seeking behavior in patients with ketamine use disorder, while the pharmacotherapy of side effects is limited and mostly symptomatic. In this chapter, we discuss ketamine abuse history. Further, we proposed the mechanisms of neural disinhibition underlying addiction development in ketamine-dependent patients. We have also included details of possible negative consequences focusing on long-term and recreational ketamine use for both, central and peripheral systems. Finally, we provide an overview of ketamine concomitant use and corresponding adverse interactions.","PeriodicalId":134765,"journal":{"name":"Ketamine Revisited - New Insights into NMDA Inhibitors [Working Title]","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130182787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Role of Ketamine as Part of the Anti-Hyperalgesic Approach in Opioid-Free Anesthesia (OFA) and Postoperative Analgesia (OFAA) 氯胺酮在无阿片类药物麻醉(OFA)和术后镇痛(OFAA)中的作用

Ketamine Revisited - New Insights into NMDA Inhibitors [Working Title] Pub Date : 2021-10-18 DOI: 10.5772/intechopen.100424

C. Ramírez-Paesano, Claudia Rodiera Clarens, José Carlos Torres Mandujano, Milen Bonev Bonev, Karen Salazar Loaiza, F. Borghetti, María Martínez Alberici, Josep Rodiera Olivé, Jesús Santaliestra Fierro

{"title":"Role of Ketamine as Part of the Anti-Hyperalgesic Approach in Opioid-Free Anesthesia (OFA) and Postoperative Analgesia (OFAA)","authors":"C. Ramírez-Paesano, Claudia Rodiera Clarens, José Carlos Torres Mandujano, Milen Bonev Bonev, Karen Salazar Loaiza, F. Borghetti, María Martínez Alberici, Josep Rodiera Olivé, Jesús Santaliestra Fierro","doi":"10.5772/intechopen.100424","DOIUrl":"https://doi.org/10.5772/intechopen.100424","url":null,"abstract":"There is increasing evidence of the close relationship between persistent activation of the glutaminergic pathway, central sensitization, hyperalgesia and chronic pain. Opioids have long been the standard analgesics used in the perioperative. However, their side effects, namely opioid-induced hyperalgesia, opioid tolerance and post-operative dependence in patients with chronic pain that are to undergo aggressive surgeries have motivated anesthesiologists to develop alternative anesthetic techniques. They include analgesic and anti-inflammatory drugs that act by modulating the nociceptive pathways with an opioid-sparing effect and even opioid-free anesthesia (OFA). In OFA plus postoperative analgesia (OFAA) techniques, ketamine plays a fundamental role as an analgesic with its antagonist action on the N-Methyl-D-Aspartate-receptors (NMDAr). However, ketamine is limited to use at sub-anesthetic doses (“low-doses”) due to its dose-dependent side effects. Consequently, other analgesic drugs with anti-NMDAr effects like magnesium sulfate and other non-opioid analgesics such as lidocaine and alpha-2-adrenergic agonists are often used in OFAA techniques. The aim of this text is to present a summary of the importance of the use of ketamine in OFA based on nociceptive pathophysiology. Additionally, the perioperative protocol (OFAA) with the anti-hyperalgesic approach of ketamine, lidocaine and dexmedetomidine co-administration in our center will be described. Some of the main indications for the OFAA protocol will be mentioned.","PeriodicalId":134765,"journal":{"name":"Ketamine Revisited - New Insights into NMDA Inhibitors [Working Title]","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126855065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Emergence of Ketamine as a Rapid Acting Antidepressant: Mechanistic Insights and Future Directions 氯胺酮作为速效抗抑郁药的出现:机制见解和未来方向

Ketamine Revisited - New Insights into NMDA Inhibitors [Working Title] Pub Date : 2021-09-10 DOI: 10.5772/intechopen.99765

Atamjit Singh, P. Bedi

引用次数: 0