Ketamine in acute phase of severe traumatic brain injury "an old drug for new uses?"
- PMID: 33407737
- PMCID: PMC7788834
- DOI: 10.1186/s13054-020-03452-x
Ketamine in acute phase of severe traumatic brain injury "an old drug for new uses?"
Abstract
Maintaining an adequate level of sedation and analgesia plays a key role in the management of traumatic brain injury (TBI). To date, it is unclear which drug or combination of drugs is most effective in achieving these goals. Ketamine is an agent with attractive pharmacological and pharmacokinetics characteristics. Current evidence shows that ketamine does not increase and may instead decrease intracranial pressure, and its safety profile makes it a reliable tool in the prehospital environment. In this point of view, we discuss different aspects of the use of ketamine in the acute phase of TBI, with its potential benefits and pitfalls.
Keywords: Agitation; Cooperative sedation; Ketamine; Neuroprotection; Secondary insult; Sedation; Traumatic brain injury.
Conflict of interest statement
No conflict of interest.
Similar articles
-
Safety of sedation with ketamine in severe head injury patients: comparison with sufentanil.Crit Care Med. 2003 Mar;31(3):711-7. doi: 10.1097/01.CCM.0000044505.24727.16. Crit Care Med. 2003. PMID: 12626974 Clinical Trial.
-
Ketamine as an Anesthetic for Patients with Acute Brain Injury: A Systematic Review.Neurocrit Care. 2020 Aug;33(1):273-282. doi: 10.1007/s12028-020-00975-7. Neurocrit Care. 2020. PMID: 32328972 Free PMC article.
-
Ketamine decreases intracranial pressure and electroencephalographic activity in traumatic brain injury patients during propofol sedation.Anesthesiology. 1997 Dec;87(6):1328-34. doi: 10.1097/00000542-199712000-00011. Anesthesiology. 1997. PMID: 9416717 Clinical Trial.
-
When used for sedation, does ketamine increase intracranial pressure more than fentanyl or sufentanil?Ann Emerg Med. 2015 Jan;65(1):55-6. doi: 10.1016/j.annemergmed.2014.08.017. Epub 2014 Sep 16. Ann Emerg Med. 2015. PMID: 25233812 Review. No abstract available.
-
Use of midazolam and ketamine as sedation for children undergoing minor operative procedures.Support Care Cancer. 2005 Dec;13(12):1001-9. doi: 10.1007/s00520-005-0821-8. Epub 2005 Apr 22. Support Care Cancer. 2005. PMID: 15846522
Cited by
-
Brain Injury and Ketamine study (BIKe): a prospective, randomized controlled double blind clinical trial to study the effects of ketamine on therapy intensity level and intracranial pressure in severe traumatic brain injury patients.Trials. 2025 May 28;26(1):177. doi: 10.1186/s13063-025-08835-5. Trials. 2025. PMID: 40437634 Free PMC article.
-
Resuscitation and Initial Management After Moderate-to-Severe Traumatic Brain Injury: Questions for the On-Call Shift.J Clin Med. 2024 Dec 2;13(23):7325. doi: 10.3390/jcm13237325. J Clin Med. 2024. PMID: 39685782 Free PMC article. Review.
-
Acute Effects of Ketamine on Intracranial Pressure in Children With Severe Traumatic Brain Injury.Crit Care Med. 2023 May 1;51(5):563-572. doi: 10.1097/CCM.0000000000005806. Epub 2023 Feb 21. Crit Care Med. 2023. PMID: 36825892 Free PMC article.
-
Recent advancements in the practice of neuroanaesthesia and neurocritical care: An update.Indian J Anaesth. 2023 Jan;67(1):85-90. doi: 10.4103/ija.ija_949_22. Epub 2023 Jan 21. Indian J Anaesth. 2023. PMID: 36970469 Free PMC article.
-
Causal association of plasma circulating metabolites with nephritis: a Mendelian randomization study.Front Nutr. 2024 May 3;11:1364841. doi: 10.3389/fnut.2024.1364841. eCollection 2024. Front Nutr. 2024. PMID: 38765814 Free PMC article.
References
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical