Ketamine: History, Modern View And New Opportunities: A Narrative Review



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Abstract

Ketamine, NMDA-receptor antagonist, created more than 60 years ago as an anesthetic, having survived historical ups and downs, remains relevant in modern world medical practice. Over the past few decades, it has been rediscovering its potential, going beyond anesthesia. The use of ketamine in sub-dissociative doses to treat various types of acute and chronic pain and depression is becoming an increasingly pressing topic. It is comparable in effectiveness to opioids and has few transient side effects. Ketamine can be administered in a variety of ways; it is approaching the title of ideal analgesic for the prehospital phase due to its safety profile. In patients with severe trauma, ketamine is probably the best analgesic because it provides hemodynamic stability and does not increase intracranial pressure. Ketamine is extremely useful in patients with opioid dependence, opioid tolerance, and opioid-induced hyperalgesia.The discovery of diverse targets and associated effects of ketamine make it possible to use the unique properties of this drug in many areas of clinical and experimental medicine, including anesthesiology practice, emergency care, intensive care, pain treatment, psychiatry, the study of the neurobiological foundations of consciousness, modeling of pathological mental states.

The article presents the history of the creation of ketamine, an overview of modern ideas about the mechanisms of action, methods and areas of its application.

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About the authors

Tatiana Linkova

Author for correspondence.
Email: linkovat@gmail.com
ORCID iD: 0000-0003-1272-1350
Russian Federation

Andrey V. Diordiev

Scientific practical center of pediatric psychoneurology; The Russian National Research Medical University named after N.I. Pirogov

Email: avddoc@mail.ru
ORCID iD: 0000-0001-9973-0211
SPIN-code: 3210-5074
119602, Moscow

Marina S. Panova

Scientific and Practical Center for Child Psychoneurology

Email: panova_ms@bk.ru
ORCID iD: 0009-0004-4347-2531
SPIN-code: 8412-4628
Russian Federation, Moscow

Ekaterina S. Iakovleva

Scientific and Practical Center for Child Psychoneurology

Email: iakovlevadoc@gmail.com
ORCID iD: 0000-0003-3143-5069
SPIN-code: 1620-0503
Russian Federation, Moscow

Ivan I. Afukov

Russian National Research Medical University named after N.I. Pirogov; Children’s City Clinical Hospital No. 9

Email: afukovdoc@yandex.ru
ORCID iD: 0000-0001-9850-6779
Russian Federation, Moscow; Moscow

Roman V. Shagurin

Scientific and Practical Center for Child Psychoneurology

Email: roman.sharugin@yandex.ru
ORCID iD: 0009-0002-2425-8973
SPIN-code: 2632-1265
Russian Federation, Moscow

Elina S. Ivanina

Clinical and Research Institute of Emergency Pediatric Surgery and Trauma — Dr. Roshal's Clinic

Email: ivanina.eli@yandex.ru
ORCID iD: 0009-0001-7684-7836
SPIN-code: 3369-1107
Russian Federation, Moscow

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