氯胺酮：是抗癫痫药还是促癫痫药？一项系统评价。
Ketamine: Pro or antiepileptic agent? A systematic review.
作者信息
Shehata Islam Mohammad, Kohaf Neveen A, ElSayed Mohamed W, Latifi Kaveh, Aboutaleb Aya Moustafa, Kaye Alan David
机构信息
Ain Shams University, Cairo, Egypt.
Department of Clinical Pharmacy, Alazhar, University, Cairo, 11651, Egypt.
出版信息
Heliyon. 2024 Jan 10;10(2):e24433. doi: 10.1016/j.heliyon.2024.e24433. eCollection 2024 Jan 30.
PURPOSE
of Review: This evidence-based systematic review evaluated the safety of ketamine as regard the potential to provoke epilepsy to help better guide anesthesiologists in their practice.
RECENT FINDINGS
Ketamine, originally developed as a dissociative anesthetic, has gained attention for its potential therapeutic applications in various medical conditions, including epilepsy. Ketamine is generally well-tolerated and widely used in anesthesia, however, conflicting data are confusing the anesthesiologists regarding the potential risk of seizures associated with its use. The literature that claimed the proepileeptic property are inconsistent and the mechanism of action is unclear. Moreover, the case reports had been in same certain contexts, such as procedural sedation where ketamine was used as a single agent. On the other hand, the retrospective data analysis confirmed the positive role ketamine plays as antiepileptic agent.
SUMMARY
Many studies have shown promising results for the use of ketamine as antiepileptic agent. In case of epileptic patients, there is no contraindication for using ketamine, however, combining with benzodiazepine or propofol may enhance the safety.
综述目的
本循证系统评价评估了氯胺酮诱发癫痫的潜在安全性，以帮助麻醉医生在实践中更好地做出指导。
最新发现
氯胺酮最初作为解离麻醉剂开发，因其在包括癫痫在内的各种医疗状况中的潜在治疗应用而受到关注。氯胺酮通常耐受性良好且广泛用于麻醉，然而，相互矛盾的数据让麻醉医生对其使用相关的癫痫发作潜在风险感到困惑。声称氯胺酮具有促癫痫特性的文献并不一致，其作用机制尚不清楚。此外，病例报告多处于特定背景下，如氯胺酮作为单一药物用于程序镇静时。另一方面，回顾性数据分析证实了氯胺酮作为抗癫痫药物的积极作用。
总结
许多研究表明氯胺酮作为抗癫痫药物使用前景良好。对于癫痫患者，使用氯胺酮没有禁忌证，然而，与苯二氮䓬类药物或丙泊酚联合使用可能会提高安全性。
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