Brinck Elina, Kontinen Vesa
Duodecim. 2017;133(9):863-8.
Ketamine is an old anesthetic agent that relieves pain by reducing central sensitization in the central nervous system. This is advantageous for patients suffering from severe pain prior to surgery or are using a strong opioid. The S enantiomer of ketamine used for anesthesia is more powerful than racemic ketamine. The ideal dose of ketamine for pain relief is not yet known, and its adverse effects on the central nervous system, including hallucinations, sedation, and diplopia have limited its use in pain management. The significance of these effects at low doses is probably less than expected, particularly if benzodiazepines or an alpha-2 agonist, such as dexmedetomidine, are administered in addition to ketamine.
氯胺酮是一种古老的麻醉剂，通过减轻中枢神经系统的中枢敏化来缓解疼痛。这对术前患有严重疼痛或正在使用强效阿片类药物的患者有利。用于麻醉的氯胺酮S对映体比消旋氯胺酮更有效。用于缓解疼痛的氯胺酮理想剂量尚不清楚，其对中枢神经系统的不良反应，包括幻觉、镇静和复视，限制了其在疼痛管理中的应用。低剂量时这些影响的重要性可能低于预期，特别是如果除氯胺酮外还给予苯二氮䓬类药物或α-2激动剂，如右美托咪定。
