Korean J Anesthesiol.  2021 Apr;74(2):103-114. 10.4097/kja.20663.

Comeback of ketamine: resurfacing facts and dispelling myths

• Kumar A
• Kohli A

• KMID: 2514493
• DOI: http://doi.org/10.4097/kja.20663

Abstract

Initially known as CI-581, ketamine was first synthesized in 1962 as a replacement from phencyclidine. It has since been used as an anesthetic and analgesic. In addition, it has bronchodilating, sedative, and amnestic properties, preserving airway reflexes and sympathetic nervous system tone. Since the discovery of ketamine, it has been a major topic of discussion due to controversies regarding its usage in particular sets of patients. In the past 50 years, despite its potential benefits, it is not commonly used because of concerns of “emergence phenomenon,” its use as a substance of abuse, and its systemic side effects. Since 2012, three World Health Organization reviews on ketamine have addressed its international control. Researchers have been studying this wonder drug for a decade worldwide. Many myths of ketamine regarding emergence phenomenon and its use in traumatic brain injury and open eye injury have been disproved in recent times. It is becoming popular in pre-hospital settings, critical care, emergency medicine, low-dose acute pain services, and adjuvant in regional anesthesia techniques. This review highlights the current consensus on the various applications of ketamine in the literature.

Keyword

Ketamine, Intracranial pressure; Intraocular pressure; Acute pain services; Chronic cancer pain; Emergence reaction; Alcohol withdrawal; Status epilepticus