Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Apr-Jun;34(2):287-294.
doi: 10.5935/0103-507X.20220027-pt.

Ketamine use in critically ill patients: a narrative review

[Article in Portuguese, English]
Thais Dias Midega  1 , Renato Carneiro de Freitas Chaves  1 , Carolina Ashihara  2 , Roger Monteiro Alencar  3 , Verônica Neves Fialho Queiroz  2 , Giovana Roberta Zelezoglo  1 , Luiz Carlos da Silva Vilanova  1 , Guilherme Benfatti Olivato  1 , Ricardo Luiz Cordioli  1 , Bruno de Arruda Bravim  1 , Thiago Domingos Corrêa  1
Affiliations
Review

Ketamine use in critically ill patients: a narrative review

[Article in Portuguese, English]
Thais Dias Midega et al. Rev Bras Ter Intensiva. 2022 Apr-Jun.

Abstract
in English, Portuguese

Ketamine is unique among anesthetics and analgesics. The drug is a rapid-acting general anesthetic that produces an anesthetic state characterized by profound analgesia, preserved pharyngeal-laryngeal reflexes, normal or slightly enhanced skeletal muscle tone, cardiovascular and respiratory stimulation, and occasionally a transient and minimal respiratory depression. Research has demonstrated the efficacy of its use on anesthesia, pain, palliative care, and intensive care. Recently, it has been used for postoperative and chronic pain, as an adjunct in psychotherapy, as a treatment for depression and posttraumatic stress disorder, as a procedural sedative, and as a treatment for respiratory and/or neurologic clinical conditions. Despite being a safe and widely used drug, many physicians, such as intensivists and those practicing in emergency care, are not aware of the current clinical applications of ketamine. The objective of this narrative literature review is to present the theoretical and practical aspects of clinical applications of ketamine in intensive care unit and emergency department settings.

A cetamina é única entre os anestésicos e analgésicos. A droga é um anestésico geral de ação rápida que produz um estado anestésico caracterizado por analgesia profunda, reflexos faríngeolaríngeos preservados, tônus músculo esquelético normal ou ligeiramente aumentado, estimulação cardiovascular e respiratória e, ocasionalmente, insuficiência respiratória transitória e mínima. Estudos demonstraram a eficácia de seu uso em anestesia, na dor, em cuidados paliativos e em cuidados intensivos. Recentemente, tem sido empregada para dores pós-operatórias e crônicas, como coadjuvante em psicoterapia, como tratamento para depressão e transtorno de estresse pós-traumático, como sedativo para procedimentos cirúrgicos e como tratamento para condições clínicas respiratórias e/ou neurológicas. Apesar de ser um medicamento seguro e amplamente utilizado, muitos médicos, como intensivistas e emergencistas, não estão cientes das aplicações clínicas atuais da cetamina. O objetivo desta revisão bibliográfica narrativa é apresentar aspectos teóricos e práticos das aplicações clínicas da cetamina em ambientes de unidade de terapia intensiva e serviços de emergência.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest: None

References

    1. White PF, Way WL, Trevor AJ. Ketamine--its pharmacology and therapeutic uses. Anesthesiology. 1982;56(2):119–136. - PubMed
    1. Strayer RJ, Nelson LS. Adverse events associated with ketamine for procedural sedation in adults. Am J Emerg Med. 2008;26(9):985–1028. - PubMed
    1. Green SM, Clark R, Hostetler MA, Cohen M, Carlson D, Rothrock SG. Inadvertent ketamine overdose in children: clinical manifestations and outcome. Ann Emerg Med. 1999;34(4 Pt 1):492–497. - PubMed
    1. Cohen SP, Bhatia A, Buvanendran A, Schwenk ES, Wasan AD, Hurley RW, et al. Consensus Guidelines on the Use of Intravenous Ketamine Infusions for Chronic Pain From the American Society of Regional Anesthesia and Pain Medicine, the American Academy of Pain Medicine, and the American Society of Anesthesiologists. Reg Anesth Pain Med. 2018;43(5):521–546. - PMC - PubMed
    1. Mankowitz SL, Regenberg P, Kaldan J, Cole JB. Ketamine for rapid sedation of agitated patients in the prehospital and emergency department settings: a systematic review and proportional meta-analysis. J Emerg Med. 2018;55(5):670–681. - PubMed