Tawfic Qutaiba A
FIBMS (Anesthesiology), Clinical Fellow, Acute Pain Service, Department of Anesthesiology, The Ottawa Hospital (TOH)-University of Ottawa, Ottawa, Ontario, Canada K1Y 4E9.
J Opioid Manag. 2013 Sep-Oct;9(5):379-88. doi: 10.5055/jom.2013.0180.
Ketamine is a noncompetitive antagonist of N-methyl-d-aspartate receptor. It has been widely used in anesthesia and pain management. Ketamine has been administered via the intravenous, intramuscular, subcutaneous, oral, rectal, topical, intranasal, sublingual, epidural, and caudal routes. Ketamine improves postoperative and posttrauma pain scores and reduces opioid consumption. It has special indication for patients with opioid tolerance, acute hyperalgesia, and neuropathic pain. It also has a role in the management of chronic pain including both cancer and noncancer pain. Recreational use of ketamine is increasing as well through different routes of administration like inhalation, smoking, or intravenous injection. Long-time exposure to ketamine, especially in the abusers, may lead to serious side effects. This review is trying to define the role of ketamine in pain management.
氯胺酮是N-甲基-D-天冬氨酸受体的非竞争性拮抗剂。它已广泛应用于麻醉和疼痛管理。氯胺酮可通过静脉、肌肉、皮下、口服、直肠、局部、鼻内、舌下、硬膜外和骶管途径给药。氯胺酮可改善术后和创伤后疼痛评分，并减少阿片类药物的使用。它对阿片类药物耐受、急性痛觉过敏和神经性疼痛患者有特殊适应症。它在慢性疼痛（包括癌症和非癌症疼痛）的管理中也有作用。通过吸入、吸烟或静脉注射等不同给药途径，氯胺酮的娱乐性使用也在增加。长期接触氯胺酮，尤其是滥用者，可能会导致严重的副作用。本综述旨在确定氯胺酮在疼痛管理中的作用。
